HIV Transmission Prevention

2017 ◽  
Author(s):  
Carolyn Chu ◽  
Christopher M. Bositis
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
Risk Groups ◽  
Antiviral Drugs ◽  
Antiretroviral Drugs ◽  
Post Exposure Prophylaxis ◽  
Needle Exchange Programs ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Prevention Of Hiv

The prevention of HIV transmission involves a number of behavioral, structural, and biomedical interventions. Behavioral methods include education about sexual health, drug use, and risk reduction, as well as specific messages for at-risk populations who are HIV positive. Needle exchange programs and consistent use of condoms have proven effective for prevention of HIV infection. Post-exposure prophylaxis against HIV with antiviral drugs is often recommended in occupational health care and non-occupational settings. Voluntary male circumcision also reduces the risk of HIV acquisition. The treatment of pregnant women who are HIV infected can effectively eliminate mother-to-child transmission of the virus. Recently, the use of antiretroviral drugs for pre-exposure prophylaxis has proven highly effective in preventing HIV infections in high-risk groups including men who have sex with men. Promising therapies that likely will be available in the future include injectable antiviral drugs, vaginal microbicides, and HIV vaccines.

Post-exposure prophylaxis

2002 ◽  
Vol 13 (1_suppl) ◽  
pp. 30-34 ◽  
Author(s):  
◽  
Marchina E Van Der Ende ◽  
Rosa M Regez ◽  
Gerrit Schreij ◽  
Jan T M Van Der Meer ◽  
...  
Keyword(s):  
The Netherlands ◽  
Hiv Transmission ◽  
Standard Procedure ◽  
High Plasma ◽  
Antiretroviral Drugs ◽  
Post Exposure Prophylaxis ◽  
Serious Adverse Events ◽  
Post Exposure ◽  
Occupational Setting ◽  
Exposure Prophylaxis

The mean risk of acquiring HIV after an occupational exposure, injecting drug use or sexual exposure varies from <0.1 to 3%. A high plasma HIV-RNA of the source increases the risk of each of the exposures. Other factors, such as the volume of the inoculum involved to which the individual was exposed, other sexually transmitted diseases and ruptures of mucous membranes are associated with a higher risk of HIV transmission. Based on the calculated risk, post-exposure prophylaxis (PEP) should be recommended. In the Netherlands, prescription of PEP in the occupational setting is a standard procedure and has proved to be feasible. This was associated with a high percentage (62%) of mild and reversible toxicity and a small percentage (2%) of serious adverse events related to antiretroviral drugs, i.e. nephrolithiasis (due to indinavir) and toxic hepatitis (due to nevirapine). In The Netherlands so far no HIV-seroconversions have been recorded after an occupational accident.

scholarly journals Trends in HIV pre-exposure prophylaxis use in eight Canadian provinces, 2014–2018

2021 ◽  
Vol 47 (56) ◽  
pp. 251-258
Author(s):  
Nashira Popovic ◽  
Qiuying Yang ◽  
Chris Archibald
Keyword(s):  
Hiv Transmission ◽  
Age Distribution ◽  
Hiv Infections ◽  
Fold Increase ◽  
Hiv And Aids ◽  
Post Exposure Prophylaxis ◽  
Aids Epidemic ◽  
Canadian Provinces ◽  
Almost All ◽  
Exposure Prophylaxis

Introduction: Canada has endorsed the Joint United National Programme on HIV and AIDS global targets to end the acquired immunodeficiency syndrome (AIDS) epidemic, including reducing new human immunodeficiency virus (HIV) infections to zero, by 2030. Given the effectiveness of pre-exposure prophylaxis (PrEP) to prevent new infections, it is important to measure and report on PrEP utilization to help inform planning for HIV prevention programs and policies. Methods: Annual estimates of persons using PrEP in Canada were generated for 2014–2018 from IQVIA’s geographical prescription monitor dataset. An algorithm was used to distinguish users of tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for PrEP versus treatment or post-exposure prophylaxis. We provide the estimated number of people using PrEP in eight Canadian provinces by sex, age group, prescriber specialty and payment type. Results: The estimated number of PrEP users increased dramatically over the five-year study period, showing a 21-fold increase from 460 in 2014 to 9,657 in 2018. Estimated PrEP prevalence was 416 users per million persons across the eight provinces in 2018. Almost all PrEP users were male. Use increased in both sexes, but increase was greater for males (23-fold) than females (five-fold). Use increased across all provinces, although there were jurisdictional differences in the prevalence of use, age distribution and prescriber types. Conclusion: The PrEP use in Canada increased from 2014 to 2018, demonstrating increased awareness and uptake of its use for preventing HIV transmission. However, there was uneven uptake by age, sex and geography. Since new HIV infections continue to occur in Canada, it will be important to further refine the use of PrEP, as populations at higher risk of HIV infection need to be offered PrEP as part of comprehensive sexual healthcare.

Post-exposure prophylaxis in the era of pre-exposure prophylaxis: a study of post-exposure prophylaxis use in South-East Queensland since the Pharmaceutical Benefits Scheme listing of pre-exposure prophylaxis

2020 ◽  
Vol 31 (5) ◽  
pp. 426-431
Author(s):  
Karen Biggs ◽  
Maree O’Sullivan ◽  
Cheryn Palmer ◽  
Jacqualine McLellan ◽  
Fiona Marple-Clark ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
Condom Use ◽  
Antiretroviral Drugs ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
The Impact ◽  
Pharmaceutical Benefits Scheme

Both post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) involve the use of antiretroviral drugs taken by HIV-uninfected individuals to reduce HIV acquisition risk. While PEP has been available in Australia for many years, PrEP became widely accessible in 2018 after listing on the Pharmaceutical Benefits Scheme (PBS). Studies have reported on the impact of PrEP on condom use. The impact of PrEP on the use of PEP in Australia has not been reported. This project examined PEP use across three public sexual health services in South-East Queensland, Australia, comparing rates in 2016 (prePBS-listed PrEP) and 2019 (postPBS-listed PrEP), to determine if PEP prescribing, and the characteristics of people accessing PEP, have changed. Results showed that PEP prescribing made up 2.85% of all clients seen in 2016, dropping to 2.33% in 2019, reflecting a decrease of 0.5% (p = 0.048). There was a significant increase in Medicare-ineligible clients accessing PEP (9% in 2016; 21% in 2019; p = 0.002) and a significant increase in PrEP-experienced clients accessing PEP between the two study periods (4% in 2016; 14% in 2019; p ≤ 0.001). The marginal decrease in PEP prescribing highlights that PEP remains an important option especially for those with barriers to accessing and adhering to daily PrEP.

scholarly journals New Canadian guideline provides evidence-based approach to non-occupational HIV prophylaxis

CJEM ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 21-25
Author(s):  
Shannon O’Donnell ◽  
Darrell H. S. Tan ◽  
Mark W. Hull
Keyword(s):  
Hiv Transmission ◽  
Occupational Exposures ◽  
Hiv Infections ◽  
Risk Exposure ◽  
Post Exposure Prophylaxis ◽  
Evidence Based ◽  
Post Exposure ◽  
Canadian Guideline ◽  
Key Points ◽  
Exposure Prophylaxis

AbstractThe incidence of HIV infections in Canada has increased yearly since 2014. New cases of HIV have resulted almost exclusively from non-occupational exposures, including sexual contact and needle sharing. Appropriate HIV post-exposure prophylaxis is under-prescribed to patients who present to the emergency department after a high-risk exposure. In November of 2017, a Canadian guideline on HIV pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) was published. The guideline presents a standardized, evidence-based approach to assessing risk for HIV transmission and prescribing HIV prophylaxis. This summary highlights the key points from the guideline that are relevant to the practice of emergency medicine in Canada.

Prevention Strategies Against HIV Transmission: A Proactive Approach

2017 ◽  
Vol 31 (1) ◽  
pp. 82-90 ◽  
Author(s):  
Antonio J. Carrion ◽  
Jovan D. Miles ◽  
Juan F. Mosley ◽  
Lillian L. Smith ◽  
April S. Prather ◽  
...  
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Hiv Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Post Exposure Prophylaxis ◽  
Proactive Approach ◽  
Highly Active ◽  
Department Of Health ◽  
Immunodeficiency Virus ◽  
Exposure Prophylaxis

Human immunodeficiency virus (HIV) has now transformed into a manageable chronic condition. Highly active antiretroviral therapy (HAART) has proven efficacious at controlling the disease progression. Based on compelling evidence, the Department of Health and Human Services (DHHS) and the Infectious Disease Society of America (IDSA) developed guidelines for the management of persons infected with HIV. However, there are approximately 50 000 new cases of HIV in the United States each year. In this article, we review proactive methods to reduce the transmission of HIV, which include reinforcing patient education, gel-coated condoms that destroy HIV, HIV vaccinations, and adequately utilizing pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Further development and consistent utilization of innovative prevention tools can significantly reduce the incidence of HIV infections regardless of HIV status.

scholarly journals Towards a standard HIV post exposure prophylaxis for healthcare workers in Europe

2002 ◽  
Vol 6 (34) ◽  
Author(s):  
T Thomas ◽  
V Puro
Keyword(s):  
Hiv Transmission ◽  
Management Strategies ◽  
Occupational Exposures ◽  
Antiretroviral Drugs ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
The United Kingdom ◽  
Occupational Setting ◽  
Exposure Prophylaxis ◽  
Bloodborne Infections

The transmission of HIV from patient to healthcare worker in an occupational setting was first documented in 1984 (1). In countries that have surveillance and HIV testing systems to recognise occupationally acquired cases, over 100 cases of HIV transmission after an occupational exposure were reported worldwide up to June 1999 (2). Antiretroviral drugs are used for post-exposure prophylaxis (PEP), and zidovudine alone is said to reduce transmission of HIV by 81% (3), but failures of PEP have been documented (4). The European Commission has recently funded a project to develop guidelines for the standardised management of occupational exposures to HIV/bloodborne infections and evaluation of PEP in Europe. The EuRoPEP (European Registry of Post-Exposure Prophylaxis) project is coordinated by the Istituto Nazionale per le Malattie Infettive, Lazzaro Spallanzani, Rome, and involves a group of expert representatives from Croatia, Denmark, France, Germany, Italy, Portugal, Spain, Switzerland, and the United Kingdom. The group presented two abstracts at the XIV International AIDS Conference in Barcelona, Spain (7-12 July 2002, http://www.aids2002.com/). The first assessed current policies and practice for the management of occupational exposures and PEP (5); the second aimed to provide a set of recommendations based on a review of national management strategies as discussed during a consensus meeting (6), and copies are available on request: ([email protected]).

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections

2020 ◽  
Vol 19 (3) ◽  
pp. 242-248
Author(s):  
Anthony Idowu Ajayi ◽  
Mohammed Sanusi Yusuf ◽  
Elmon Mudefi ◽  
Oladele Vincent Adeniyi ◽  
Ntombana Rala ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P&lt; 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P&lt; 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P&lt; 0.001), pregnancy (39.0% vs 79.6%; P&lt; 0.001), syphilis (3.4% vs 89.8%; P&lt; 0.001), hepatitis B (15.3% vs 95.5%; P&lt; 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

scholarly journals HIV prevention strategies and risk of infection: a model-based analysis

2018 ◽  
Vol 146 (8) ◽  
pp. 1015-1025 ◽  
Author(s):  
A. Hahn ◽  
R. Hinz ◽  
T. Meyer ◽  
U. Loderstädt ◽  
O. Herchenröder ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Transmission ◽  
Hiv Infections ◽  
Risk Groups ◽  
Unprotected Sex ◽  
Transmission Risk ◽  
Prevention Strategies ◽  
Hiv Prevention Strategies ◽  
Hiv Transmission Risk

AbstractRisk populations for HIV infections tend to neglect condom use, making alternative preventive approaches necessary. Accordingly, we modelled the risk of sexual HIV transmission for condom usevs.use of rapid diagnostic test (RDT) systems with subsequent exclusion of potential sexual partners with a correctly or falsely positive test from unprotected sex with and without the use of HIV pre-exposure prophylaxis (PrEP) in a bio-statistical approach. We combined a previously described model of transmission risk for HIV-exposed individuals with a newly suggested model of risk of HIV exposure for sexually active HIV-negative individuals. The model was adapted for several stages of infection and different strategies of HIV infection prevention.HIV prevention with RDTs can reduce the transmission risk by up to 97% compared with having sex without any prevention and up to 80% compared with condom use. Nevertheless, RDT-based prevention strategies demonstrate a lack of protection in several stages of infection; in particular, RNA-based RDT systems may fail under treatment. RDT-based pre-screening of potential sex partners prior to unprotected sexual contacts substantially reduces HIV transmission risk. Combination of different prevention strategies is advisable for high-risk groups.

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