Biomedical HIV prevention research and epidemic control in Thailand: two sides of the same coin

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 180 ◽  
Author(s):  
Frits van Griensven ◽  
Nittaya Phanuphak ◽  
Kriengkrai Srithanaviboonchai
Keyword(s):  
Hiv Prevention ◽  
Role Model ◽  
Initial Response ◽  
Prevention Research ◽  
Global Management ◽  
Biomedical Hiv Prevention ◽  
Aids Pandemic ◽  
And Control ◽  
Two Sides ◽  
Hiv Aids

For a country with a moderate adult HIV prevalence of just over 1% in 2012, Thailand is widely perceived as having made some extraordinary contributions to the global management of the HIV/AIDS pandemic. It has been promoted as a model of effective HIV control and applauded for its leadership in providing access to antiretroviral treatment. Thailand has also received international recognition for its contribution to biomedical HIV prevention research, which is generally perceived as exceptional. In this paper, Thailand’s global role model function as an example of effective HIV/AIDS control and high-quality biomedical HIV prevention research is re-evaluated against the background of currently available data and more recent insights. The results indicate that Thailand’s initial response in raising the level of the political significance of HIV/AIDS was indeed extraordinary, which probably prevented a much larger epidemic from occurring. However, this response transpired in unusual extraconstitutional circumstances and its effectiveness declined once the country returned to political normalcy. Available data confirm the country’s more than exceptional contribution to biomedical HIV prevention research. Thailand has made a huge contribution to the global management and control of the HIV/AIDS pandemic.

Epidemiology of HIV in Iran

2020 ◽  
Vol 18 (4) ◽  
pp. 228-236
Author(s):  
Zeinab Najafi ◽  
Leila Taj ◽  
Omid Dadras ◽  
Fatemeh Ghadimi ◽  
Banafsheh Moradmand ◽  
...  
Keyword(s):  
Middle East ◽  
Hiv Prevention ◽  
Prevention And Control ◽  
Hiv Transmission ◽  
Health Management ◽  
Key Populations ◽  
Mena Region ◽  
First Case ◽  
And Control ◽  
Hiv Aids

: Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

scholarly journals Speculations on Quasi-Experimental Design in HIV/AIDS Prevention Research

2012 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
Donald T. Campbell ◽  
Beatrice J. Krauss
Keyword(s):  
Experimental Design ◽  
Hiv Prevention ◽  
Research Design ◽  
Research Community ◽  
Experimental Designs ◽  
Prevention Research ◽  
Quasi Experimental ◽  
Aids Research ◽  
Speculative Discussion ◽  
Hiv Aids

This paper provides a speculative discussion on what quasi-experimental designs might be useful in various aspects of HIV/AIDS research. The first author’s expertise is in research design, not HIV, while the second author has been active in HIV prevention research. It is hoped that it may help the HIV/AIDS research community in discovering and inventing an expanded range of possibilities for valid causal inference. DOI:10.2458/azu_jmmss_v3i1_campbell

Homo adhaerens: Risk and adherence in biomedical HIV prevention research

2020 ◽  
Vol 50 (6) ◽  
pp. 860-880
Author(s):  
Clay Davis
Keyword(s):  
Clinical Trials ◽  
Hiv Prevention ◽  
The United States ◽  
Magic Bullet ◽  
Prevention Research ◽  
Prophylactic Regimen ◽  
Hiv Therapy ◽  
Making Sense ◽  
Biomedical Hiv Prevention ◽  
Exposure Prophylaxis

After the turn of the millennium, HIV clinical researchers pivoted from developing and testing new antiretrovirals (ARVs) for treatment, to reconfiguring the same molecules for pre-exposure prophylaxis (PrEP). In 2012, Truvada became the first HIV therapy to also be approved by the FDA for PrEP, regarded as a magic bullet that promised to end the epidemic. However, six years after its approval, it continues to be inaccessible to those who are most vulnerable. In this article, I critically analyze HIV PrEP clinical trials, dissecting the novel techniques researchers use to demonstrate efficacy. I argue that in making sense of the interplay between adherence to a prophylactic regimen and risk for HIV, biomedical HIV prevention research has revealed a new subject of biopolitics, Homo adhaerens. In the early 2000s, clinical researchers operating in the Global South identified Homo adhaerens as the ideal subject, one who embodies both high-risk behavior and diligent adherence to a daily oral regimen. I trace the construction of Homo adhaerens to the United States, where I listen closely to activists engaged with the ongoing DISCOVER trial of PrEP. Activists either aspire for Homo adhaerens as a standard, making the liberal argument that expanding access could make PrEP successful, or they rebuke the framework of clinical research that produces narrow understandings of adherence, efficacy, and universality. Ultimately, I argue that by failing to grapple with the social realities that underlie poor adherence, PrEP clinical trials produce knowledge that is not useful for those who are most vulnerable.

scholarly journals Parents’ Perspectives About Adolescent Boys’ Involvement in Biomedical HIV Prevention Research

2017 ◽  
Vol 47 (7) ◽  
pp. 1923-1935 ◽  
Author(s):  
Brian Mustanski ◽  
Kathryn Macapagal ◽  
Matthew Thomann ◽  
Brian A. Feinstein ◽  
Michael E. Newcomb ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Research ◽  
Adolescent Boys ◽  
Biomedical Hiv Prevention

scholarly journals Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template

2016 ◽  
Vol 25 (7) ◽  
pp. 761-766 ◽  
Author(s):  
Richard H. Beigi ◽  
Lisa Noguchi ◽  
Gina Brown ◽  
Jeanna Piper ◽  
D. Heather Watts
Keyword(s):  
Hiv Prevention ◽  
Drug Safety ◽  
Prevention Research ◽  
Biomedical Hiv Prevention ◽  
Safety Research ◽  
Pregnancy And Lactation

scholarly journals Gender and Power Dynamics of Social Relationships Shape Willingness to Participate in Biomedical HIV Prevention Research Among South African Adolescents and Young Adults

2021 ◽  
Vol 3 ◽  
Author(s):  
Kalysha Closson ◽  
Laura Lee ◽  
Janan J. Dietrich ◽  
Mags E. Beksinska ◽  
Stefanie Hornschuh ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
South African ◽  
Young Women ◽  
Ecological Model ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Power Dynamics ◽  
Prevention Research ◽  
Willingness To Participate ◽  
Biomedical Hiv Prevention

Background: Understanding young women and men's perceived barriers and facilitators to participation in biomedical HIV prevention research is important for designing youth friendly services (YFS) and acceptable technologies, which are necessary for preventing high sustained HIV incidence in South Africa. This study explores the multileveled barriers and facilitators to young men and women's willingness to participate in hypothetical biomedical HIV prevention research.Methods: Eight age- (16–18 and 19–24 years) and gender-stratified focus group discussions (FGDs) were conducted using semi-structured interview guides to explore young South African women and men's willingness, perceived barriers, and facilitators to participating in biomedical HIV prevention research. FGD transcripts were uploaded to NVivo and coded collaboratively with youth study team members. Thematic analysis using Bronfenbrenner's ecological model (individual, inter-personal, community, and societal) was used to guide a deductive coding procedure, which was documented and compared by gender.Results: Thirty-one participants from Durban and 34 from Soweto participated in FGDs. Individual facilitators for participation were discussed more by young men and included financial incentives and altruism. Concerns about side-effects of biomedical products were a common barrier. Interpersonal relationships with peers, intimate partners and caregivers influenced young people's willingness to participate in HIV prevention research, more so among young women. For young women, gendered power dynamics and distrust of intimate partners and parents influenced both communication regarding participation and willingness to participate in research that is often stigmatized, due to societal norms around women's sexuality. On a societal level, participants expressed distrust in medical and research institutions, however a sense of community that was developed with the study staff of this project, was a motivator to participate in future studies.Discussion: At each level of the ecological model, we found participants expressed gendered barriers and facilitators for participation. Gender norms as well as distrust of partners, parents, and health care professionals were key barriers that cut across all levels. At each level participants discussed facilitators that were youth-engaged, underscoring the need to implement YFS, establish trust and address gender inequities within future biomedical HIV prevention studies wishing to engage and retain South African youth.

Toward a New Health Strategy to Control the HIV/AIDS Pandemic

1994 ◽  
Vol 22 (1) ◽  
pp. 41-52 ◽  
Author(s):  
Jonathan Mann ◽  
Daniel Tarantola ◽  
Jeff O’Malley
Keyword(s):  
Hiv Prevention ◽  
Behavioral Change ◽  
World Health ◽  
Aids Pandemic ◽  
Health Strategy ◽  
The World ◽  
Information Materials ◽  
Health Organization ◽  
Influence Behavior ◽  
Hiv Aids

Since its recognition in the early 1980s, the global HIV/AIDS pandemic has continued to grow relentlessly. Early efforts in HIV prevention sought to influence behavior by providing information about the dangers of AIDS along with recommendations for safe behavior. This approach helped to alert people about AIDS, but was insufficient to promote or sustain behavioral change.The second approach attempted to promote individual behavioral change by designing AIDS programs that would deliver a mix of information, materials, and services. This program-based approach emerged within communities, was gradually adopted by some countries, and was subsequently articulated by the World Health Organization as the first Global AIDS Strategy. The emphasis during this period was to ensure that each community and country developed its own comprehensive program by adapting a global model to local and national circumstances.

Research Synthesis, HIV Prevention Response, and Public Health: CDC’s HIV/AIDS Prevention Research Synthesis Project

2021 ◽  
pp. 003335492098887
Author(s):  
Linda J. Koenig ◽  
Cynthia M. Lyles ◽  
Darrel Higa ◽  
Mary M. Mullins ◽  
Theresa A. Sipe
Keyword(s):  
Public Health ◽  
Hiv Prevention ◽  
Systematic Reviews ◽  
Research Synthesis ◽  
Aids Prevention ◽  
Prevention Programs ◽  
The United States ◽  
Research Translation ◽  
Prevention Research ◽  
Hiv Aids

Objective Research synthesis, through qualitative or quantitative systematic reviews, allows for integrating results of primary research to improve public health. We examined more than 2 decades of work in HIV prevention by the Centers for Disease Control and Prevention’s (CDC’s) HIV/AIDS Prevention Research Synthesis (PRS) Project. We describe the context and contributions of research synthesis, including systematic reviews and meta-analyses, through the experience of the PRS Project. Methods We reviewed PRS Project publications and products and summarized PRS contributions from 1996 to July 2020 in 4 areas: synthesis of interventions and epidemiologic studies, synthesis methods, prevention programs, and prevention policy. Results PRS Project publications summarized risk behaviors and effects of prevention interventions (eg, changing one’s perception of risk, teaching condom negotiation skills) across populations at risk for HIV infection and intervention approaches (eg, one-on-one or group meetings) as the HIV/AIDS epidemic and science evolved. We used the PRS Project cumulative database and intervention efficacy reviews to contribute to prevention programs and policies through identification of evidence-based interventions and development of program guidance. Subject matter experts and scientific evidence informed PRS Project products and contributions, which were implemented through strategic programmatic partnerships. Conclusions The contributions of the PRS Project to HIV prevention and public health efforts in the United States can be credited to CDC’s long-standing support of the project and its context within a federal prevention agency, where HIV programs and policies were developed and implemented. The effect of the PRS Project was likely facilitated by opportunities to directly influence program and policy because of connections with other research translation activities and program and policy decision making within CDC.

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