 This is a randomized the study medication is assigned by chance, active controlled participants are assigned to either a recognized effective treatment or the study medication study. This study consists of 3 phases: screening phase 4 weeks, treatment phase 96 weeks, and follow up phase 4 weeks. In the treatment phase, participants will be randomly assigned to 1 of the 4 treatment groups: 1 TMC278 25 mg, 2 TMC278 75 mg, 3 TMC278 150 mg, or 4 efavirnez control group; along with investigator selected 2 non-nucleoside reverse transcriptase inhibitor NRTIs until Week 96. TMC278 will be assigned by double-blinded fashion participant and investigator are not aware of the TMC278 dose what participants will receive and efavirnez will be assigned by open-label fashion all people know what treatment participants will receive. After Week 96, 3 optional open-label all people know the identity of the intervention extension periods will be conducted to collect long term safety and effectiveness data of TMC278. 3 optional extension periods are: first optional extension period all participants will receive TMC278 75 mg 2 NRTIs from Week 96 to Week144; second optional extension period all participants will receive TMC278 25 mg 2 NRTIs from Week 144 to Week 240; and third optional extension period all participants will receive TMC278 25 mg 2 NRTIs from Week 240 until TMC278 is commercially available. Participants on efavirenz group will have the option to continue on efavirenz 2 NRTIs until the total treatment duration of 240 weeks. Safety evaluations will include assessment of adverse events, clinical laboratory tests, electrocardiogram, physical examination, and vital signs which will be monitored throughout the study. The maximum duration of the study will be 104, 152, or 248 weeks, plus the optional third extension period. 