Timing of Initiation of First-line Antiretroviral Therapy

  • Authors: Marshall J. Glesby, MD, PhD; Timothy J. Wilkin, MD, MPH (More Info)
  • Section Editor: Joel E. Gallant, MD, MPH
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 4/1/16 (What's New)


  • Treatment guidelines recommend that ART should be offered to patients at risk for transmitting HIV, such as those engaging in sex with HIV-uninfected partners or those with unknown serostatus (Management Guidelines)[DHHS ART]
  • Early initiation of ART has also been proposed for specific populations to reduce “community viral load” and the risk of sexual transmission of HIV per sex act within a sexual network[Stall 2008; Das 2010]
    • Theoretically, this strategy prevents HIV infections by drastically reducing the number of people likely to transmit HIV[Granich 2009]

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