scholarly journals The review of pre-exposure prophylaxis (PreP) for HIV prevention

2014 ◽  
Vol 11 (1) ◽  
pp. 50-59
Author(s):  
Meriam Caboral Stevens ◽  
Godfrey Aneke ◽  
Andrew Neplock
Keyword(s):  
Hiv Prevention ◽  
Global Health ◽  
Hiv Infection ◽  
Condom Use ◽  
Biomedical Research ◽  
Prevention Strategies ◽  
Global Health Issue ◽  
Exposure Prophylaxis ◽  
Current Guidelines ◽  
Prevention Of Hiv

Human lmmunodeficiency Virus (HlV) epidemic continues to represent a major global health issue. Today, there are several tools available to prevent the spread of HIV infection. However, there are several constraints to the current prevention strategies including low condom use, low acceptance of testing, low awareness of vulnerability and more emphasis on treatment. Prevention strategy is redirected towards reducing acquisition of HIV. Pre-exposure prophylaxis or PrEP is the latest groundbreaking innovation in biomedical research in the prevention of HIV transmission.The purpose of this paper is to review preex ding the current guidelines in the use of PreP.

scholarly journals Quality of HIV Websites With Information About Pre-Exposure Prophylaxis or Treatment as Prevention for Men Who Have Sex With Men: Systematic Evaluation (Preprint)

2018 ◽  
Author(s):  
Taylor Silverman ◽  
Nicole Asante ◽  
Jacob J van den Berg
Keyword(s):  
Hiv Prevention ◽  
Hiv Infection ◽  
Rating Scale ◽  
The United States ◽  
Treatment As Prevention ◽  
Key Words And Phrases ◽  
Prevention Strategies ◽  
Hiv Prevention Strategies ◽  
Sex With Men ◽  
Exposure Prophylaxis

BACKGROUND Knowledge and uptake of high-efficacy HIV prevention strategies such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) remain low among men who have sex with men (MSM) who are at the highest risk for HIV infection in the United States. Electronic health (eHealth) interventions are promising tools for disseminating information about these critical yet underutilized strategies and addressing key barriers to uptake among target populations. However, existing HIV prevention websites are understudied and unevaluated. OBJECTIVE This study aimed to systematically review and evaluate existing HIV websites that include information about PrEP or TasP for MSM. METHODS From March 2018 to May 2018, 2 trained research assistants (RAs) entered relevant key words and phrases into 3 commonly used search engines and applied exclusion criteria to all returned results to identify 31 websites included in this review. RAs independently scored each website for authority, usability, interactivity, and PrEP/TasP-related content based on a standardized rating scale and then averaged the results. RESULTS No website received a perfect score in any of the 4 categories, and the average website score was 62% (37/60). Less than a quarter of the websites (23%, 7/31) received a score of more than 75% (7.5/10) for content. Approximately two-thirds of the websites (65%, 20/31) received a score of 50% (5/10) or lower for interactivity. The average score in usability was 68% (6.8/10) and in authority was 69% (6.9/10). Other deficiencies observed included difficulty locating relevant content and lack of information targeting audiences with the highest likelihood of HIV infection. CONCLUSIONS Existing HIV prevention websites with information about PrEP or TasP for MSM fail to provide adequate content as well as present that content to users in an interactive and audience-conscious way. Future eHealth interventions should attempt to rectify these deficiencies to successfully engage and educate MSM at high risk for HIV regarding prevention strategies.

scholarly journals Birth Cohort Variations Across Functional Knowledge of HIV Prevention Strategies, Perceived Risk, and HIV-Associated Behaviors Among Gay, Bisexual, and Other Men Who Have Sex With Men in the United States

2018 ◽  
Vol 12 (6) ◽  
pp. 1824-1834 ◽  
Author(s):  
Akshay Sharma ◽  
Erin M. Kahle ◽  
Stephen P. Sullivan ◽  
Rob Stephenson
Keyword(s):  
Hiv Prevention ◽  
Birth Cohort ◽  
Perceived Risk ◽  
The United States ◽  
Prevention Strategies ◽  
The Past ◽  
Hiv Prevention Strategies ◽  
Functional Knowledge ◽  
Sex With Men ◽  
Exposure Prophylaxis

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.

scholarly journals Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Southern African HIV Clinicians Society Consensus Committee
Keyword(s):  
At Risk ◽  
Renal Function ◽  
Hiv Prevention ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Fixed Dose ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

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.

ATTITUDES TOWARDS CONDOM USE FOR PREVENTION OF HIV INFECTION IN BOTSWANA

2004 ◽  
Vol 32 (5) ◽  
pp. 491-510 ◽  
Author(s):  
Edward E. Marandu ◽  
Mbaki A. Chamme
Keyword(s):  
Hiv Infection ◽  
Condom Use ◽  
Theory Development ◽  
Personal Interview ◽  
Policy Action ◽  
Negative Attitudes ◽  
Cultural Traditions ◽  
Almost All ◽  
Main Barrier ◽  
Prevention Of Hiv

Attitudes to condom use for prevention of HIV infection in Botswana were examined. Data collection was by personal interview of 1349 respondents throughout the country. Alcohol is believed to be the single main barrier to condom use. Others include: beliefs that condoms are not effective, emotional barriers to condom use, cultural traditions and complacency. Men appear to have a greater tendency to agree with beliefs that encourage nonuse of condoms. There was evidence to suggest that a holder of an attitude in one area such as cultural belief is likely to hold a similar attitude in almost all other areas. The implication of this finding for theory development is that attitudes are not independent of each other. The implications for policy action are straightforward: an effective strategy for attacking the negative attitudes should put emphasis on men and be broadly educative in the sense of attacking several attitudes simultaneously, rather than one at a time.

scholarly journals Challenges and opportunities for oral pre-exposure prophylaxis in the prevention of HIV infection: where are we in Europe?

BMC Medicine ◽  
2013 ◽  
Vol 11 (1) ◽  
Author(s):  
Jean-Michel Molina ◽  
Claire Pintado ◽  
Caroline Gatey ◽  
Diane Ponscarme ◽  
Pierre Charbonneau ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Challenges And Opportunities ◽  
Exposure Prophylaxis ◽  
Prevention Of Hiv

scholarly journals PrEP in India’s HIV Prevention Policy in the Era of Social Media and Sex Positivity

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Anindya Kar ◽  
Dinesh Bhugra ◽  
Shuvankar Mukherjee ◽  
Agnibho Mondal ◽  
Aaditya Suresh Kumar
Keyword(s):  
Social Media ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
International Studies ◽  
Cultural Transition ◽  
Prevention Policy ◽  
Online Social Media ◽  
Seeking Behavior ◽  
The Government ◽  
Exposure Prophylaxis

Introduction: The global revolution of online social media and connectivity had a tremendous effect on sexual behavior in both developed and developing countries. This global change is influencing the societal structure and existing social principles. Moreover, it has a significant impact on the epidemiology of different infectious diseases, especially HIV.Discussion: India is one of the most diverse democratic countries that has undergone a social-cultural transition in the last decade. However, having the second-highest HIV infection rate in the world, India does not have any other new prevention tools in their national HIV prevention strategy. Pre-Exposure Prophylaxis (PrEP), a boon of HIV prevention widely used in different countries, is still not implemented in India. The concept of “Digital India” by the Government of India is giving wide access of internet to the people of India. Furthermore, people are exposed to social media, and that is impacting their sex seeking behavior. Interestingly, recent legal changes in India promotes sex positivity. It also calls for introspection on existing HIV preventive strategies.Conclusion: Given the current scenario of PrEP and other existing preventive measurements of HIV, further research is needed to determine the acceptance and efficacy of PrEP and improve engagement in care for individuals in India. Various international studies recommend effective implication of PrEP to reduce the rate and economic burden of HIV infection.

scholarly journals Women’s estimated HIV infections from sex in trials of pre-exposure prophylaxis in Africa: Implications for HIV prevention strategies

2017 ◽  
Author(s):  
David Gisselquist
Keyword(s):  
Hiv Prevention ◽  
Hiv Infections ◽  
Common Belief ◽  
Prevention Strategies ◽  
Sexual Risks ◽  
Hiv Prevention Strategies ◽  
Vaginal Gels ◽  
Vaginal Rings ◽  
Exposure Prophylaxis ◽  
Oral Prep

AbstractIntroductionDuring 2004-15, nine randomized controlled trials (RCT) for HIV prevention tested pre-exposure prophylaxis (PrEP) with oral drugs, vaginal gels, or vaginal rings among more than 17,000 women in Africa.MethodsThis study uses information from the nine RCTs to estimate the proportions of HIV from sexual and bloodborne risks, to consider reasons for success or failure with oral PrEP, and to consider risks with vaginal PrEP.ResultsEstimating from women’s reported frequencies of unprotected coital acts in six RCTs, only a minority of women’s infections came from sex. Oral PrEP may have succeeded in at least one trial by reducing infections from both bloodborne and sexual risks. Oral PrEP may have failed in several trials, at least in part, because some women used oral PrEP when they had sexual risks rather than daily as advised. Relatively high incidence with PrEP vaginal gels and rings vs. oral placebo suggests vaginal PrEP had little impact at best and may have been harmful.DiscussionEvidence from this and other studies challenges the common belief most HIV in Africa comes from sex. This challenge has implications for HIV prevention strategies, including: warning about bloodborne risks; and reconsidering PrEP for young women.

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