Hayes RJ, et al. - In order to determine the influence of universal testing and treatment on human immunodeficiency virus (HIV) incidence, experts randomized 21 communities in Zambia and South Africa (approximately 1 million individuals) to group A (combination prevention intervention with universal antiretroviral therapy [ART]), group B (the prevention intervention with ART provided according to local guidelines [universal since 2016]), or group C (standard care) through the HPTN 071 (PopART) community-randomized investigation carried out from 2013 through 2018. A total of 48,301 individuals were included in the study. A total of 553 new HIV infections were seen during 39,702 person-years between months 12 and 36. The percentage of HIV-positive participants with viral suppression at 24 months was 71.9%, 67.5% and 60.2% in group A, B and C, respectively. The percentage of HIV-positive adults in the community who were receiving ART in group A and group B at 36 months was estimated to be 81% and 80 %, respectively. Hence, a combination prevention intervention with ART rendered in line with local guidelines led to a 30% reduced incidence of HIV infection vs standard care. The lack of impact with universal ART was not expected and did not match the data on viral suppression.