Thinking about public health impact should inform HIV curative investigations. Should an effective HIV cure or sustained viral remission intervention emerge from ongoing investigations, implementation strategies aimed at ensuring global access will be needed if these approaches are to be impactful, and planning accordingly makes sense now. Specifically, we discuss three key access barriers to future cure-related interventions: high cost of the strategy; non-financial challenges to procurement, distribution and point-of-care delivery; and non-adherence and the need for long-term monitoring. As we argue, plans and decision-making for overcoming each of these barriers will need to be developed in advance. An evaluation of remaining barriers and likely global impact of the leading strategies under investigation should inform decisions on which strategy might receive funding priority. Among the strategies being investigated, implementation barriers for latency-reversing agents, immunotherapy and combination antiretroviral therapy (ART) may be overcome on a global scale with some effort. Overcoming implementation barriers for medically complex and high-risk interventions, such as stem cell and, to some degree, gene therapy, may be less feasible.

考虑公共卫生影响应为艾滋病治疗调查提供依据。如果正在进行的调查显示出有效的HIV治愈或持续的病毒缓解干预措施，那么，要想使这些方法具有影响力，就需要制定旨在确保全球可及性的实施策略，因此现在就应该进行规划。具体来说，我们讨论了未来与治愈相关的干预措施的三个主要障碍：策略成本高；采购，分配和现场护理交付方面的非财务挑战；和不遵守以及需要进行长期监控。正如我们所争论的那样，需要预先制定克服这些障碍的计划和决策。对所研究的主要战略的剩余障碍和可能的全球影响的评估应为哪种战略可能获得资金优先的决策提供依据。在正在研究的策略中，潜伏期逆转剂，免疫疗法和抗逆转录病毒联合疗法（ART）的实施障碍可能会在全球范围内有所克服。克服医学上复杂且高风险的干预措施（例如干细胞和某种程度上的基因治疗）的实施障碍可能不太可行。