The presence of elevated HIV viral load within blood and genital secretions is a critical driver of transmission events. Long-term suppression of viral load to undetectable levels through the use of antiretroviral therapy is now standard practice for clinical management of HIV. Antiretroviral therapy therefore can play a key role as a means to curb HIV transmission. Results of a randomized clinical trial, in conjunction with several observational studies, have now confirmed that antiretroviral therapy markedly decreases HIV transmission risk. Mathematical models and population-based ecologic studies suggest that further expansion of antiretroviral coverage within current guidelines can play a major role in controlling the spread of HIV. Expansion of so-called "Treatment as Prevention" initiatives relies upon maximal uptake of the HIV continuum-of-care cascade to allow for successful identification of those not yet known to be HIV-infected, engagement of patients in appropriate care, and subsequently achieving sustained virologic suppression in patients with the use of antiretroviral therapy. Since 2010, the Joint United Nations AIDS (UNAIDS) program has called for the inclusion of antiretroviral treatment as a key pillar in the global strategy to control the spread of HIV infection. This has now been invigorated by the release of the World Health Organization's 2013 Consolidated Antiretroviral Therapy Guidelines, recommending treatment to be offered to all HIV-infected individuals with CD4 cell counts below 500/mm3, and, regardless of CD4 cell count, to serodiscordant couples, TB and HBV co-infected individuals, pregnant women, and children below the age of 5 years.

中文翻译：

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艾滋病毒治疗作为预防：无艾滋病一代的关键

血液和生殖器分泌物中 HIV 病毒载量升高是传播事件的关键驱动因素。通过使用抗逆转录病毒疗法将病毒载量长期抑制到检测不到的水平，现在是 HIV 临床管理的标准做法。因此，抗逆转录病毒疗法可以作为遏制艾滋病毒传播的一种手段发挥关键作用。一项随机临床试验的结果，结合几项观察性研究，现已证实抗逆转录病毒疗法显着降低了 HIV 传播风险。数学模型和基于人群的生态学研究表明，在当前指南范围内进一步扩大抗逆转录病毒的覆盖范围可以在控制 HIV 传播方面发挥重要作用。扩大所谓的“治疗即预防” 这些举措依赖于最大限度地采用 HIV 连续护理级联，以成功识别那些尚未感染 HIV 的人，让患者参与适当的护理，并随后在使用抗逆转录病毒药物的患者中实现持续的病毒学抑制治疗。自 2010 年以来，联合国艾滋病联合计划 (UNAIDS) 一直呼吁将抗逆转录病毒治疗作为控制 HIV 感染传播全球战略的关键支柱。世界卫生组织 2013 年联合抗逆转录病毒治疗指南的发布使这一点更加活跃，该指南建议向所有 CD4 细胞计数低于 500/mm3 的 HIV 感染者提供治疗，并且无论 CD4 细胞计数如何，都应向血清学不一致的夫妇提供治疗, TB 和 HBV 合并感染者，