scholarly journals Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Linda-Gail Bekker ◽  
Kevin Rebe ◽  
Francois Venter ◽  
Gary Maartens ◽  
Michelle Moorhouse ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Guidelines ◽  
World Health ◽  
Combination Prevention ◽  
Transgender Persons ◽  
Sex With Men ◽  
Health Organization ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP) guidelines in June 2012 for men who have sex with men (MSM) who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO) Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

scholarly journals Minimum dataset for monitoring national human immunodeficiency virus pre-exposure prophylaxis (HIV PrEP) programmes: a five-nation consensus, 2019

2021 ◽  
Vol 26 (23) ◽  
Author(s):  
John Saunders ◽  
O Noel Gill ◽  
Valerie Delpech ◽  
Claudia Estcourt ◽  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Health Planning ◽  
Monitoring And Evaluation ◽  
World Health ◽  
Surveillance Systems ◽  
Combination Prevention ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Hiv Acquisition ◽  
Exposure Prophylaxis

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), the use of antiretroviral medication to prevent HIV acquisition, is a highly effective biomedical prevention tool. The World Health Organization (WHO) recommends PrEP for people at substantial risk of HIV infection, as part of combination prevention, and highlights the need for robust evaluation of PrEP programmes. Based on suggested WHO core indicators, we created a concise set of HIV PrEP-related dataset variables, to harmonise the monitoring and evaluation of PrEP programmes across five closely related nations (England, Northern Ireland, Ireland, Scotland and Wales). The dataset is based on the PrEP cascade and is intended to represent the minimum variables needed for reporting and comparison of meaningful data at national and multinational level. The dataset can be modified for settings with different health and surveillance systems. It is intended for public health, academic, clinical and health planning, and public audiences. Here we describe the dataset and illustrate its use with data from the first year of the Scottish National PrEP programme.

scholarly journals ‘Break the Chains 2015’ community-based HIV prevention campaign for men who have sex with men in Switzerland: non-randomised evaluation and cost analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032459
Author(s):  
Kathrin Frey ◽  
Stéphanie Lociciro ◽  
Patricia Blank ◽  
Matthias Schwenkglenks ◽  
Françoise Dubois-Arber ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Cost Analysis ◽  
Hiv Testing ◽  
Community Based ◽  
Prevention Campaign ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Campaign Message

ObjectivesTo study the implementation, effects and costs of Break the Chains, a community-based HIV prevention campaign for men who have sex with men (MSM) in Switzerland, from March to May 2015, which aimed to reduce early HIV transmission by promoting the campaign message to adopt short-term risk reduction followed by HIV testing.DesignNon-randomised evaluation and cost analysis.SettingGay venues in 11 of 26 cantons in Switzerland and national online media campaign.ParticipantsMSM in online surveys (precampaign n=834, postcampaign n=688) or attending HIV testing centres (n=885); campaign managers (n=9); and campaign staff (n=38) or further intermediaries (n=80) in an online survey.Primary and secondary outcome measuresThe primary outcome measure was the proportion of MSM at risk of HIV acquisition or transmission who adhered to the campaign message. Secondary outcomes were postcampaign test uptake, knowledge about HIV primary infection and sense of belonging to the gay community.ResultsCampaign staff estimated that they contacted 17 145 MSM in 11 cantons. Among 688 respondents to the postcampaign survey, 311 (45.2%) were categorised as MSM at risk. Of 402/688 (58.5%) MSM who had heard about Break the Chains 2015, MSM categorised as being at risk were less likely to report adherence to the campaign message than MSM not at risk (adjusted OR 0.24; 95% CI 0.14 to 0.42). Twenty per cent of MSM with a defined risk of HIV acquisition or transmission who adopted risk reduction declared having done so because of the campaign. Costs for one MSM at risk to adhere to the campaign message were estimated at USD purchasing power parity 36–55. The number of HIV tests in the month after the campaign was twice the monthly average.ConclusionBreak the Chains increased HIV testing, implying that community-based campaigns are useful HIV prevention strategies for MSM. Additional interventions are needed to reach MSM at the highest risk of infection more effectively.

High uptake of pre-exposure prophylaxis (PrEP) during early roll-out in Belgium: results from surveillance reports

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 80 ◽  
Author(s):  
Bea Vuylsteke ◽  
Thijs Reyniers ◽  
Catherine Lucet ◽  
Christiana Nöstlinger ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Disability Insurance ◽  
Aggregated Data ◽  
Increased Risk ◽  
Event Driven ◽  
Sub Saharan ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
Roll Out

Background Since 1 June 2017, oral pre-exposure prophylaxis (PrEP) could be prescribed and reimbursed in Belgium as prophylactic medication for people who are at increased risk of HIV acquisition. The aim of this study was to determine the uptake of daily and event-driven PrEP in Belgium during the first 9 months of roll-out. Methods: Routine aggregated data on the number of reimbursement requests and the number of boxes of Truvada (Gilead Sciences, Cambridge, UK) delivered for PrEP through the Belgian pharmacies were obtained from the National Institute for Health and Disability Insurance. We also collected aggregated data from seven Aids Reference Centres (ARCs) currently providing most of the PrEP care in Belgium. Results: From 1 June 2017 to 28 February 2018, 1352 requests for reimbursement were approved by the National Institute for Health and Disability Insurance. Almost 98% of those who bought at least one box of 30 tablets of emtricitabine 200mg/tenofovir disoproxil fumarate 300mg (FTC/TDF) in a Belgian pharmacy were male, and most (67%) were between 30 and 50 years of age. According to data obtained from ARCs, the proportion of those choosing event-driven PrEP initially ranged between 29% and 73%. Conclusions: The uptake of PrEP in Belgium since the start of the roll-out in June 2017 has been high, and almost entirely limited to men who have sex with men, of whom 43% initially prefer a non-daily regimen. A better understanding is needed as to why other populations, such as sub-Saharan African migrants, are not accessing PrEP, as well as the development of a more sustainable PrEP delivery model.

Early experience of implementing a national HIV pre-exposure prophylaxis service in Wales, United Kingdom 2017

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 56 ◽  
Author(s):  
Laia Fina ◽  
Amy L. Phillips ◽  
Adam T. Jones ◽  
Zoë M. Couzens ◽  
Rachel Drayton ◽  
...  
Keyword(s):  
Sexual Health ◽  
Early Experience ◽  
Hiv Positive ◽  
Transgender People ◽  
Positive Individual ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

Background Pre-exposure prophylaxis (PrEP) was introduced in Sexual Health Services of the Welsh National Health Service (NHS Wales) in July 2017 as a 3-year pilot service. Methods: Data were collected through the pre-existing Sexual Health in Wales Surveillance System, to which codes were added to capture PrEP eligibility, outcome of offer of PrEP, reasons for declining and adherence. Eligibility categories were defined based on nationally agreed criteria: men who have sex with men (MSM) and transgender people at high risk of HIV acquisition; partners of HIV-positive individuals not known to be virally suppressed; and heterosexuals reporting condomless intercourse with a HIV-positive individual not known to be virally suppressed. Results: During the first 6 months, 516 people were eligible, 96% of which were MSM. Overall, 57% of those eligible (296/516) started PrEP. Reasons for declining PrEP were given by 88 (56%) of 157 people; 50 (57%) of whom did not believe themselves to be at risk. Of the available adherence assessments, 89% considered that all risk episodes had been covered. Persistence at 3 months was assessed for 141 people, of which 93 (66%) were still using PrEP. There were no HIV diagnoses in people taking PrEP during the first 6 months. Twenty-nine people were diagnosed with 37 episodes of sexually transmissible infections (STIs) while on PrEP. STI incidence was 105.7 per 100 person-years. Conclusions: The early trend indicates that implementation of PrEP is progressing as planned, and the service has been utilised by clients. This analysis can help refine implementation, inform planning and research around uptake, use and effect in Wales and internationally.

Demand for pre-exposure prophylaxis for HIV and the impact on clinical services: Scottish men who have sex with men perspectives

2017 ◽  
Vol 29 (3) ◽  
pp. 273-277
Author(s):  
RI Gilson ◽  
DJ Clutterbuck ◽  
ZE Chen
Keyword(s):  
High Risk ◽  
Lower Risk ◽  
Clinical Services ◽  
Anonymous Questionnaire ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis ◽  
The Impact ◽  
Ability And Willingness

There is a lack of data on ability and willingness of men who have sex with men (MSM) to self-fund HIV pre-exposure prophylaxis (PrEP). We aimed to explore how many eligible (PROUD study criteria) men may want PrEP and how many lower-risk MSM would be willing and able to self-fund this intervention. A self-completed anonymous questionnaire was distributed to MSM populations attending services. Of 377 participants, 81.5% were aware of PrEP. Fifty-three (15.5 %) were eligible, of whom 43 (81%) were very/extremely likely to want it. Of those ineligible, 229 (80%) were aware of PrEP and 106 (37.3%) were very/extremely likely to want it. Of eligible respondents 23% would be willing and able to pay at least £50 a month for PrEP. Of ineligible respondents this proportion was 21%. Our survey revealed high levels of awareness, understanding and willingness to take PrEP among MSM at high and lower risk of HIV acquisition. It indicated that over 70% of high-risk men would be unwilling or unable to self-fund PrEP, should it not be available on the NHS. For lower-risk MSM we estimated that capacity requirements for monitoring self-funded PrEP will be 50% higher than numbers eligible for PrEP. These factors will need to be taken into account when planning services.

Acceptability of blood-based HIV self-testing among adolescents aged 15–19 years at risk of HIV acquisition in Bangkok

2021 ◽  
pp. 095646242110037
Author(s):  
Pongpak Phongphiew ◽  
Wipaporn N Songtaweesin ◽  
Nantika Paiboon ◽  
Panyaphon Phiphatkhunarnon ◽  
Patchareeyawan Srimuan ◽  
...  
Keyword(s):  
At Risk ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Cross Sectional ◽  
Sex With Men ◽  
Finger Stick ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Antibody Tests

Introduction: Young men who have sex with men (YMSM) and young transgender women (YTGW) in Thailand are at high HIV risk. HIV self-tests (HIVSTs) are rapidly administrable and prompt linkage to HIV treatment or prevention services. This study assesses the acceptability and feasibility of blood-based HIVST use in adolescents. Methods: A cross-sectional study was conducted among YMSM and YTGW aged 15–19 years with HIV acquisition risk. Participants completed questionnaires on the HIVST and then administered INSTI® independently, an HIVST immunoassay detecting gp41 and gp36 antibodies from finger-stick blood. Confirmatory HIV antibody tests were performed. Results: Between July and September 2020, 90 adolescents were enrolled. Mean (SD) age was 17.6 (1.1) years. Half ( N = 45) were YMSM. Forty-six (51%) were first-time HIV testers, and 32 (36%) had “ever used” HIV pre-exposure prophylaxis (PrEP). Two (2.2%, 95% CI: 0.0–5.3) tested positive, 21 (23.4%) invalid, and 67 (74.4%) negative. Invalidity causes included 17 (81%) insufficient blood, 3 (14%) buffer spillage, and 1 (5%) procedural missteps; all had negative HIV antibody tests. HIV self-test acceptability was 87.8% (95% CI: 81.0–94.5). Most (79%) preferred HIVST performance in hospital rather than at home. Conclusions: HIVSTs are acceptable in HIV at-risk adolescents. Blood-based HIVSTs should be positioned as rapid point-of-care tests with real-time linkage to HIV services.

scholarly journals Epidemiology of gonorrhoea: a global perspective

Sexual Health ◽  
2019 ◽  
Vol 16 (5) ◽  
pp. 401 ◽  
Author(s):  
Robert D. Kirkcaldy ◽  
Emily Weston ◽  
Aluisio C. Segurado ◽  
Gwenda Hughes
Keyword(s):  
Sex Workers ◽  
International Travel ◽  
Global Perspective ◽  
Indigenous Populations ◽  
World Health ◽  
International Borders ◽  
Transgender Persons ◽  
Sex With Men ◽  
Health Organization ◽  
And Control

Although understanding the local epidemiology of gonorrhoea is critical for local efforts, understanding the multinational epidemiology may support development of national and international prevention and control policies and strategies. In this paper, current epidemiology of gonorrhoea is reviewed through an international lens and with a focus on selected populations. The World Health Organization (WHO) estimates that ~87 million new gonococcal infections occurred among people aged 15–49 years in 2016. Gonorrhoea rates are rising in many countries. Gay, bisexual and other men who have sex with men, racial or ethnic minorities, Indigenous populations and sex workers appear to bear disproportionate burdens of gonorrhoea. International travel can facilitate spread of gonorrhoea, including resistant strains, across international borders. Critical gaps in epidemiological knowledge are highlighted, including data on gonorrhoea among transgender persons and the burden of extragenital gonorrhoea. Even as further data are gathered, action — informed by currently available data — is needed now to confront this growing international threat.

scholarly journals Testing brief intervention and phone contact among subjects with suicidal behavior: a randomized controlled trial in French Polynesia in the frames of the World Health Organization/Suicide Trends in At-Risk Territories study

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Stéphane Amadéo ◽  
Moerani Rereao ◽  
Aurelia Malogne ◽  
Patrick Favro ◽  
Ngoc Lam Nguyen ◽  
...  
Keyword(s):  
At Risk ◽  
World Health Organization ◽  
Brief Intervention ◽  
Suicidal Behavior ◽  
French Polynesia ◽  
World Health ◽  
Suicidal Behaviors ◽  
The World ◽  
Health Organization

The World Health Organization <em>Suicide trends in at-risk territories</em> study is a multi-site regional research program operating first in French Polynesia and countries of the Western Pacific, then extended to the world. The aims of the study were to establish a monitoring system for suicidal behaviors and to conduct a randomised control trial intervention for non-fatal suicidal behaviors. The latter part is the purpose of the present article. Over the period 2008-2010, 515 patients were admitted at the Emergency Department of the Centre Hospitalier de Polynésie Française for suicidal behavior. Those then hospitalized in the Psychiatry Emergency Unit were asked to be involved in the study and randomly allocated to either Treatment As Usual (TAU) or TAU plus Brief Intervention and Contact (BIC), which provides a psycho-education session and a follow-up of 9 phone contacts over an 18-months period. One hundred persons were assigned to TAU, while 100 participants were allocated to the BIC group. At the end of the follow-up there were no significant differences between the two groups in terms of number of presentations to the hospital for repeated suicidal behaviors. Although the study could not demonstrate the superiority of a treatment over the other, nevertheless – given its importance – the investigation captured public attention and was able to contribute to the awareness of the need of suicide prevention in French Polynesia. The BIC model of intervention seemed to particularly suit the geographical and health care context of the country.

Sign in / Sign up

Export Citation Format

Share Document