Is antiretroviral therapy modifying the HIV epidemic?/Authors' reply

[...] their surrogate for transmission- new diagnoses-is not new infections. [...] Montaner and colleagues do not report true community viral loads, but from among those who reach testing and continue on treatment. The latter two periods were characterised on a prospective basis and were entirely consistent with the predictions of our previously published mathematical models.1 Finally, we were able to relate the reductions in community plasma viral load during HAART expansion with the decrease in new HIV diagnoses, providing a plausible biological mechanism to account for the association, as proposed by others.2 We also acknowledged that the use of yearly new HIV diagnoses represented a limitation of the study; however, it is also clear that there is no widely accepted gold standard to estimate HIV incidence, particularly in population-wide studies.