Improving outcomes and managing costs of care: from the XIII International AIDS Conference

Taken as a group, these presentations endorse a treatment strategy that should improve outcomes for patients as well as manage the high costs of antiretroviral therapy. A combination of strategies that balances antiretroviral therapy with convenient, compact regimens and the use of new technologies such as viral load monitoring, therapeutic drug levels, and resistance testing can lead to improved outcomes such as fewer hospitalizations and decreased mortality. Wrapped around this strategy is an adherence program that assesses adherence and provides treatment support by helping patients overcome the myriad barriers to adherence. When one compares the treatment of HIV in developed nations with that in underdeveloped nations, the contrasts can be sobering and stark as evidenced by the descriptions of the significant barriers to treatment in other parts of the world. It is clear that while we still have significant barriers to treatment in the United States, the rest of the world looks to us for answers on how to make treatment accessible and cost-effective.