Modeled ART sequencing strategies included: one available line of ART, availability of third-line darunavir/ritonavir based ART, and additional strategies requested by the WHO HIV Guidelines Committee (Appendix).
Where data on the prevalence of HIV or ART availability among pregnant women were not available from the published article, estimates were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) for the same time period and region or country.
Data from generalized epidemic settings have consistently found that patients on antiretroviral therapy (ART) reduce sexual risk behaviours, but how sexual behaviour changes in the general population in response to ART availability, including amongst HIV-uninfected and undiagnosed adults, has not been characterized in these settings.
Although we cannot pinpoint the mechanism, we find that ART availability substantially reduces subjective mortality risk and improves mental health.
This paper shows that ART availability increases work time for HIV-negative people without caretaker obligations, who do not directly benefit from the medicine.
The study was conducted over a prolonged period with increasing ART availability.
This indicates that ART availability could provide a strong impetus for HIV testing and potentially encourage HIV prevention behaviors through awareness of HIV status [6].
More specifically, an association has been identified between decreased concern about HIV due to ART availability and unprotected sex [10], [11], [12], [13], [14].
In the developed world, various study designs have been used to investigate the impact of ART availability on risky sexual behaviors.
HIV prevention programs in sub-Saharan Africa that target the general population should include educational messages about ART and address the changing beliefs about HIV in the era of greater ART availability.
While we observed dramatic shifts in funding source at a single clinic, we recognize that the absolute level of funding at the global or national level is not the only determinant of ART availability in sub-Saharan Africa.
