The main goal of antiretroviral therapy (ART) is to achieve viral suppression, which means reducing the HIV viral load to undetectable levels. This suppresses viral replication, preventing disease progression and reducing the risk of HIV transmission. While increasing CD4 count and preventing opportunistic infections are important outcomes, they occur secondary to effective viral suppression. Reducing side effects is a management goal but not the primary objective of ART. Thus, viral suppression directly impacts patient prognosis and public health through control of the infection.

Reference: Harrison's Principles of Internal Medicine, J. Larry Jameson et al., 20th Edition.