[Antiretroviral drugs-based HIV prevention methods: what impact on the HIV epidemic?]

Thirty years after the discovery of HIV, the epidemic continues to spread. Developing new HIV prevention methods to reduce the number of new HIV infections remains a priority. It has recently been shown that antiretroviral (ARV) drugs that have largely contributed to increase life expectancy of HIV-infected people may also have a direct impact on HIV transmission. Two new ART-based HIV prevention methods have proven effective in preventing HIV infection in controlled trials and observational studies: pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP). PrEP consists of ARV drugs to be taken by HIV-negative individuals before potential HIV exposure to reduce the risk of HIV infection, while TasP consists of ARV drugs to be taken by individuals living with HIV to lower the risk of HIV transmission to others. Although these two new prevention tools have proven to be effective at the individual level, their population-level impact remains unclear. Herein in addition to reviewing current PrEP and TasP data, we discuss the potential impact of these two new prevention strategies on the HIV epidemic.