Abstract
In The Lancet HIV, John Santelli and colleagues1 show that the highly impactful combination of antiretroviral therapy (ART) and medical male circumcision has reduced orphanhood in Rakai, Uganda. Orphanhood declined from 52% in 2001–02 to 23% by 2016–18 (p<0·0001) and double orphanhood from 20% to 3% (p<0·0001).1 Concurrently, community ART use increased from 11% in 2005–06 to 78% in 2016–18, while the rates of male circumcision increased from 19% to 65%.1 These data emphasise the synergy of effective treatment and prevention strategies in improving population health outcomes, not only in adults but also in children and adolescents, by reducing orphanhood and HIV transmission risk.
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