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Clinical trials are ongoing to evaluate the model-based concept of “test and treat” (JW AIDS Clin Care Dec 15 2008), but in the meantime, modeling analyses continue to demonstrate the strategy's potential merits. The latest such analysis incorporates real-world data on the HIV epidemic among men who have sex with men (MSM) in San Francisco. This population — well-known for exceptional rates of testing, linkage to care, and retention — is ideally suited for examining the greatest potential effect of a successful test-and-treat campaign.
Four strategies were examined over a 20-year horizon:
Antiretroviral therapy (ART) initiation at CD4 counts <350 cells/mm3 (the standard of care in 2009, when this analysis was conducted)
ART initiation at CD4 c…