A detailed analysis of the source of HIV infections in Dutch gay men over more than a decade shows that 71% acquired HIV from a man who was himself not yet diagnosed. Only 6% acquired it from a man who was taking treatment.

Researchers then estimated what impact different prevention strategies would have had. They estimated that a combination of annual HIV testing, PrEP for half of all HIV-negative gay men and immediate HIV treatment for those testing positive would have prevented two thirds of these transmissions. They say the results highlight the importance of combining different interventions – just using one would have much less impact. The substantial scale-up of HIV treatment in the Netherlands has not stemmed new HIV infections. Although 90% of diagnosed men are on treatment, with 91% of those on treatment with an undetectable viral load and with 95% of diagnosed men retained in care, HIV incidence still increasing in the Netherlands. Other developed countries, including the UK, have a similar problem.

The full article can be read here.