HIV Transmission in the United States: Considerations of Viral Load, Risk Behavior, and Health Disparities, H. Irene Hall, David R. Holtgrave, Tian Tang, and Philip Rhodes; AIDS and Behavior (2013)

This article uses national survey and Centers for Disease Control data to examine the relevance of HIV status, risk behavior, and viral suppression awareness in transmission rates among risk populations. Reinforcing current prevention knowledge, the study finds that "treatment as prevention" is most effective among those who are aware of their status, have an unsuppressed viral load, and engage in risk behaviors. The authors note that disparities in viral suppression among race/ethnicity groups will continue to affect HIV incidence rates unless additional prevention efforts are implemented. As a result, the authors conclude, the National HIV/AIDS Strategy goal of increasing viral suppression by 20% among black, Latino, and men who have sex with men (MSM) populations is insufficient unless those disparities are addressed. They also suggest that resources be directed to support effective behavioral interventions including access to condoms and sterile syringes, prevention counseling, partner services, substance-abuse treatment, and medication adherence.