Human Immunodeficiency Virus Preexposure Prophylaxis in Adolescents and Young Adults

2021 ◽  
Vol 43 (1) ◽  
pp. 28-36
Author(s):  
Megan E. Brundrett
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Hiv Prevention ◽  
Hiv Transmission ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Prevention Services ◽  
Preexposure Prophylaxis ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition

Human immunodeficiency virus (HIV) prevention holds the promise of decreasing the burden of HIV infections worldwide. Access to HIV prevention services, including preexposure prophylaxis (PrEP), is a key strategy in reducing HIV transmission, but it continues to be underused. PrEP, a once-daily medication for HIV prevention, is approved for adolescents. A pediatrician’s role is critical in identifying and increasing access for adolescents and young adults to PrEP services and reducing HIV acquisition in youth.

scholarly journals Novel Strategy To Adapt Simian-Human Immunodeficiency Virus E1 Carryingenvfrom an RV144 Volunteer to Rhesus Macaques: Coreceptor Switch and Final Recovery of a Pathogenic Virus with Exclusive R5 Tropism

2018 ◽  
Vol 92 (14) ◽  
Author(s):  
Hanna B. Scinto ◽  
Sandeep Gupta ◽  
Swati Thorat ◽  
Muhammad M. Mukhtar ◽  
Anthony Griffiths ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Placebo Recipient ◽  
T Cell ◽  
Hiv Transmission ◽  
Rhesus Macaques ◽  
Phase Iii ◽  
Immunodeficiency Virus ◽  
Coreceptor Switch ◽  
Novel Strategy ◽  
Hiv Acquisition

ABSTRACTThe phase III RV144 human immunodeficiency virus (HIV) vaccine trial conducted in Thailand remains the only study to show efficacy in decreasing the HIV acquisition risk. In Thailand, circulating recombinant forms of HIV clade A/E (CRF01_AE) predominate; in such viruses,envoriginates from clade E (HIV-E). We constructed a simian-human immunodeficiency virus (SHIV) chimera carryingenvisolated from an RV144 placebo recipient in the SHIV-1157ipd3N4 backbone. The latter contains long terminal repeats (LTRs) with duplicated NF-κB sites, thus resembling HIV LTRs. We devised a novel strategy to adapt the parental infectious molecular clone (IMC), R5 SHIV-E1, to rhesus macaques: the simultaneous depletion of B and CD8+cells followed by the intramuscular inoculation of proviral DNA and repeated administrations of cell-free virus. High-level viremia and CD4+T-cell depletion ensued. Passage 3 virus unexpectedly caused acute, irreversible CD4+T-cell loss; the partially adapted SHIV had become dual tropic. Virus and IMCs with exclusive R5 tropism were reisolated from earlier passages, combined, and used to complete adaptation through additional macaques. The final isolate, SHIV-E1p5, remained solely R5 tropic. It had a tier 2 neutralization phenotype, was mucosally transmissible, and was pathogenic. Deep sequencing revealed 99% Env amino acid sequence conservation; X4-only and dual-tropic strains had evolved independently from an early branch of parental SHIV-E1. To conclude, our primate model data reveal that SHIV-E1p5 recapitulates important aspects of HIV transmission and pathobiology in humans.IMPORTANCEUnderstanding the protective principles that lead to a safe, effective vaccine against HIV in nonhuman primate (NHP) models requires test viruses that allow the evaluation of anti-HIV envelope responses. Reduced HIV acquisition risk in RV144 has been linked to nonneutralizing IgG antibodies with a range of effector activities. Definitive experiments to decipher the mechanisms of the partial protection observed in RV144 require passive-immunization studies in NHPs with a relevant test virus. We have generated such a virus by insertingenvfrom an RV144 placebo recipient into a SHIV backbone with HIV-like LTRs. The final SHIV-E1p5 isolate, grown in rhesus monkey peripheral blood mononuclear cells, was mucosally transmissible and pathogenic. Earlier SHIV-E passages showed a coreceptor switch, again mimicking HIV biology in humans. Thus, our series of SHIV-E strains mirrors HIV transmission and disease progression in humans. SHIV-E1p5 represents a biologically relevant tool to assess prevention strategies.

scholarly journals The South African Nurse’s Knowledge of Occupational Human Immunodeficiency Virus Postexposure Prophylaxis in the Era of Controlled and Stable HIV Prevalence

2020 ◽  
Vol 10 (21) ◽  
pp. 7784 ◽  
Author(s):  
Melitah Molatelo Rasweswe ◽  
Mmapheko Doriccah Peu
Keyword(s):  
Human Immunodeficiency Virus ◽  
Work Experience ◽  
Hiv Infections ◽  
Hiv Prevalence ◽  
Postexposure Prophylaxis ◽  
Work Related ◽  
Healthcare Settings ◽  
Immunodeficiency Virus ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

Knowledge is a crucial aspect of nursing. Nurses, just like any other healthcare workers (HCWs), are empowered with the knowledge of Human Immunodeficiency Virus (HIV) Postexposure Prophylaxis (PEP) protocol to be followed, including post-exposure to blood and body fluids (BBFs). The utilization of HIV PEP demonstrated its capabilities to prevent HCWs from HIV infections. However, the practice in healthcare settings remains a challenge, as many HCWs do not adhere to the protocol. This study investigated how knowledgeable nurses are about HIV PEP in the era of controlled and stable HIV prevalence. Ninety-four nurses completed a self-administered questionnaire to provide information. A biostatistician assisted with data analysis, using Microsoft Excel converted to the STATA 13 format. Most (77.0%) were female with a mean age of 30 ± 9 years. The degree of knowledge was low, although the results showed that 90.43% of nurses had been informed about HIV PEP. Eighty (84%) did not know where to access HIV PEP, and (55.32%) were unaware of HIV PEP guidelines. A comparison between knowledge and work experience revealed that those with five years and less experience are less knowledgeable. There is a need to improve nurses’ knowledge of HIV PEP to reduce the risk of HIV acquisition from work-related activities.

scholarly journals Implementation of Syringe Services Programs to Prevent Rapid Human Immunodeficiency Virus Transmission in Rural Counties in the United States: A Modeling Study

2019 ◽  
Vol 70 (6) ◽  
pp. 1096-1102 ◽  
Author(s):  
William C Goedel ◽  
Maximilian R F King ◽  
Mark N Lurie ◽  
Sandro Galea ◽  
Jeffrey P Townsend ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Transmission ◽  
Virus Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Single Infection ◽  
Agent Based ◽  
Immunodeficiency Virus ◽  
Barriers To Implementation ◽  
Scott County

Abstract Background Syringe services programs (SSPs) are effective venues for delivering harm-reduction services to people who inject drugs (PWID). However, SSPs often face significant barriers to implementation, particularly in the absence of known human immunodeficiency virus (HIV) outbreaks. Methods Using an agent-based model, we simulated HIV transmission in Scott County, Indiana, a rural county with a 1.7% prevalence of injection drug use. We compared outcomes arising in the absence of an SSP, in the presence of a pre-existing SSP, and with implementation of an SSP after the detection of an HIV outbreak among PWID over 5 years following the introduction of a single infection into the network. Results In the absence of an SSP, the model predicted an average of 176 infections among PWID over 5 years or an incidence rate of 12.1/100 person-years. Proactive implementation averted 154 infections and decreased incidence by 90.3%. With reactive implementation beginning operations 10 months after the first infection, an SSP would prevent 107 infections and decrease incidence by 60.8%. Reductions in incidence were also observed among people who did not inject drugs. Conclusions Based on model predictions, proactive implementation of an SSP in Scott County had the potential to avert more HIV infections than reactive implementation after the detection of an outbreak. The predicted impact of reactive SSP implementation was highly dependent on timely implementation after detecting the earliest infections. Consequently, there is a need for expanded proactive SSP implementation in the context of enhanced monitoring of outbreak vulnerability in Scott County and similar rural contexts.

scholarly journals Point-of-Care Testing to Guide Treatment and Estimate Risk Factors for Sexually Transmitted Infections in Adolescents and Young People With Human Immunodeficiency Virus in Eswatini

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Caitlyn L Jasumback ◽  
Sarah H Perry ◽  
Tara E Ness ◽  
Martha Matsenjwa ◽  
Zandile T Masangane ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Sexually Transmitted Infections ◽  
Sexual Partner ◽  
Adolescents And Young Adults ◽  
World Health ◽  
Sexually Active ◽  
Sexually Transmitted ◽  
Life Years ◽  
Immunodeficiency Virus

Abstract Background The World Health Organization (WHO) estimates 127 million new cases of Chlamydia trachomatis (CT), 87 million new cases of Neisseria gonorrhea (NG), and 156 million new cases of Trichomonas vaginalis (TV) each year, which corresponds to 355 (219–606), 303 (216–468), and 243 (97.6–425) thousand disability-adjusted life-years. In low-resource settings, however, sexually transmitted infections (STIs) are treated syndromically and many individuals with asymptomatic infection may be missed, especially adolescents and young adults with human immunodeficiency virus (HIV). Methods We enrolled patients aged 15–24 with HIV (N = 300) attending a family-centered HIV clinic in Mbabane, Eswatini. Participants completed a sexual history questionnaire and provided urine as well as oropharyngeal and/or vaginal swabs, if sexually active, for testing with Xpert CT/NG and TV tests. Analysis included bivariate and multivariate odds ratios and test sensitivity and specificity. Results Sexually transmitted infection rates were highest (25.0%; 95% confidence interval [CI], 15.2–37.3) in females ages 20–24 who were ever sexually active. In patients with confirmed STIs, NG (15 of 32, 47%) was more common than CT (9 of 32, 28%) and TV (8 of 32, 25%). Syndromic screening alone had a sensitivity of 32.0% (95% CI, 14.9–53.3) and specificity of 86.0% (95% CI, 79.0–91.4) but varied by gender. The presence of an STI was associated with reporting new sexual partner(s) (OR = 2.6; 95% CI, 1.1–6.4), sometimes to never using condoms (OR = 4.2; 95% CI, 1.7–10.2), most recent sexual partner >25 years old (OR = 3.2; 95% CI, 1.3–7.9), and HIV diagnosis at age ≥15 years (OR = 3.4; 95% CI, 1.4–8.2). Conclusions Syndromic screening alone performed poorly. Routine diagnostic testing significantly increases STI detection and should be considered in high-risk populations, such as adolescents and young adults with HIV.

scholarly journals Preexposure Prophylaxis for Human Immunodeficiency Virus (HIV) Prevention Among HIV–uninfected Pregnant Women

2018 ◽  
Vol 45 (12) ◽  
pp. e98-e100 ◽  
Author(s):  
Jillian Pintye ◽  
Benson Singa ◽  
Kennedy Wanyonyi ◽  
Janet Itindi ◽  
John Kinuthia ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hiv Prevention ◽  
Pregnant Women ◽  
Preexposure Prophylaxis ◽  
Immunodeficiency Virus
Sign in / Sign up

Export Citation Format

Share Document