This conference responds to the ongoing debate about the role of antiretroviral therapy for HIV prevention in Sub-Saharan Africa. In practice, antiretroviral therapy in developing countries is most often delayed until the HIV patient is severely immunocompromised (< 200 CD4+ cells /ùL). Earlier onset of antiretroviral treatment (< 350 or < 500 CD4+ cells /ùL) however, leads to longer periods of suppressed viral load (hence suppressed infectiousness) among a larger (and younger) population. This strategy could indirectly lower the HIV incidence, and would thus help to curb the epidemic. Advantages and disadvantages of this pro-active, out-of-the-box approach will be discussed in detail, based on clinical, epidemiological and health economic evidence.