March 5 (UPI) -- Nations throughout Africa have faced some of the worst HIV infections rates in the world, but new research could soon reverse that trend, a new study says.
The HIV rate in southern African communities has fallen by 30 percent as a result of house-to-house voluntary testing and treatment, according to results from a study announced at the Conference on Retroviruses and Opportunistic Infections in Seattle.
The findings come from a large trial called Population Effects of Antiretroviral Therapy to Reduce HIV Transmission, or PopART.
"The results of the PopART study suggest that conducting population-wide, home-based HIV testing and offering treatment to those diagnosed with HIV could help control the epidemic in certain settings," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. "These findings indicate that a universal test-and-treat strategy could be an important addition to our toolbox of proven HIV prevention modalities."
Between 2013 and 2018, researchers conducted the study in 21 communities throughout South Africa and Zambia. The populations totaled roughly 1 million people.
Under PopART, people received annual house-to-house voluntary HIV testing and counseling. Those tested HIV positive were immediately offered antiretroviral therapy, or ART. Those who didn't test positive still received HIV prevention awareness counseling.
People who tested positive received treatment following national guidelines based on T-cell count. The number is a measure of immune health.
When the study began, the T-cell threshold was below 350 cells per microliter. In 2014, it was lifted to 400. Two years later, the guideline numbers were discarded and ART treatment was immediately recommended.
"We found very strong evidence of an effect in the group that received treatment according to national guidelines," Richard Hayes, a researcher at the London School of Hygiene & Tropical Medicine and study author, said in a news release. "The absence of a clear reduction in HIV incidence in the group that received the most intensive HIV prevention intervention is surprising and inconsistent with the group's rate of viral suppression. Further analyses of qualitative and quantitative data from the study communities may help us better understand this unexpected result."
In contrast, another group in the study followed the same plan as the first group but didn't adhere to the national guidelines during any year of the study.
A third group also received HIV testing and prevention interventions that followed the local standards, along with HIV treatment that adhered to national guidelines.
HIV suppression rates in the first group were 72 percent, 68 percent in the second group and 60 percent in the third group.
The aim of the trial was to figure out whether conducting HIV testing and quickly treating people who test positive would suppress the virus and reduce new infection rates in those communities.
"The HPTN 071 (PopART) study, the largest HIV prevention study conducted to date, highlights the importance of conducting large-scale studies that aim to measure the impact of an integrated prevention strategy," said Wafaa El-Sadr, co-principal investigator of the NIH-funded HIV Prevention Trials Network. "Achieving HIV epidemic control will require the integration of various evidence-based interventions tailored to the needs of specific populations."