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Journal of the International AIDS Society

Carlos F Cáceres, Linda-Gail Bekker, Peter Godfrey-Faussett
No abstract text is available yet for this article.
2016: Journal of the International AIDS Society
Gus P Cairns, Kane Race, Pedro Goicochea
Pre-exposure prophylaxis (PrEP) has been and continues to be an intervention that causes controversy and debate between stakeholders involved in providing or advocating for it, and within communities in need of it. These controversies extend beyond the intrinsically complex issues of making it available. In this commentary, some of the possible roots of the air of dissent and drama that accompanies PrEP are explored. The similarities between the controversies that dogged the earliest human trials of PrEP and the ones we see today in the era of licensing and implementation are explored...
2016: Journal of the International AIDS Society
Iryna Zablotska, Andrew E Grulich, Nittaya Phanuphak, Tarandeep Anand, Surang Janyam, Midnight Poonkasetwattana, Rachel Baggaley, Frits van Griensven, Ying-Ru Lo
INTRODUCTION: HIV epidemics in the Asia-Pacific region are concentrated among men who have sex with men (MSM) and other key populations. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention and could be a potential game changer in the region. We discuss the progress towards PrEP implementation in the Asia-Pacific region, including opportunities and barriers. DISCUSSION: Awareness about PrEP in the Asia-Pacific is still low and so are its levels of use...
2016: Journal of the International AIDS Society
Giovanni Ravasi, Beatriz Grinsztejn, Ricardo Baruch, Juan Vicente Guanira, Ricardo Luque, Carlos F Cáceres, Massimo Ghidinelli
INTRODUCTION: Despite progress in scaling up antiretroviral treatment, HIV prevention strategies have not been successful in significantly curbing HIV incidence in Latin America. HIV prevention interventions need to be expanded to target the most affected key populations with a combination approach, including new high impact technologies. Oral pre-exposure prophylaxis (PrEP) is recommended as additional prevention choice for individuals at higher risk of infection and could become a cost-effective prevention tool...
2016: Journal of the International AIDS Society
Rosalind L Coleman, Susie McLean
INTRODUCTION: The offer of pre-exposure prophylaxis (PrEP) is recommended as an additional option for HIV prevention for people at substantial risk of HIV infection as part of combination HIV prevention approaches. Implementing this depends on integrating PrEP in public health programmes that address risky practices with evidence-based interventions, and that operate in an enabling legal and policy environment for the delivery of health services to those at higher risk of HIV infection...
2016: Journal of the International AIDS Society
Carlos F Cáceres, Annick Borquez, Jeffrey D Klausner, Rachel Baggaley, Chris Beyrer
BACKGROUND: In this article, we present recent evidence from studies focused on the implementation, effectiveness and cost-effectiveness of pre-exposure prophylaxis (PrEP) for HIV infection; discuss PrEP scale-up to date, including the observed levels of access and policy development; and elaborate on key emerging policy and research issues to consider for further scale-up, with a special focus on lower-middle income countries. DISCUSSION: The 2015 WHO Early Release Guidelines for HIV Treatment and Prevention reflect both scientific evidence and new policy perspectives...
2016: Journal of the International AIDS Society
Sybil Hosek, Connie Celum, Craig M Wilson, Bill Kapogiannis, Sinead Delany-Moretlwe, Linda-Gail Bekker
INTRODUCTION: Adolescents and young adults aged <25 are a key population in the HIV epidemic, with very high HIV incidence rates in many geographic settings and a large number who have limited access to prevention services. Thus, any biomedical HIV prevention approach should prepare licensure and implementation strategies for young populations. Oral pre-exposure prophylaxis (PrEP) is the first antiretroviral-based prevention intervention with proven efficacy across many settings and populations, and regulatory and policy approvals at global and national levels are occurring rapidly...
2016: Journal of the International AIDS Society
Jae M Sevelius, Madeline B Deutsch, Robert Grant
INTRODUCTION: Globally, transgender ("trans") women are one of the key populations most disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is the newest and most promising biomedical HIV prevention intervention to date. This paper reviews relevant literature to describe the current state of the science and describes the potential role of PrEP among trans women, including a discussion of unique considerations for maximizing the impact of PrEP for this vulnerable population...
2016: Journal of the International AIDS Society
Jessica B McGillen, Sarah-Jane Anderson, Timothy B Hallett
INTRODUCTION: The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape...
2016: Journal of the International AIDS Society
Sheena Mary McCormack, Veronica Noseda, Jean-Michel Molina
INTRODUCTION: In contrast to the global trend showing a decline in new HIV infections, the number reported in the World Health Organization (WHO) region of Europe is increasing. Health systems are disparate, but even countries with free access to screening and treatment observe continuing high rates of new infections in key populations, notably men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) is only available in France. This commentary describes the European epidemics and healthcare settings where PrEP could be delivered, how need might be estimated for MSM and the residual barriers to access...
2016: Journal of the International AIDS Society
Frances M Cowan, Sinead Delany-Moretlwe, Eduard J Sanders, Nelly R Mugo, Fernand A Guedou, Michel Alary, Luc Behanzin, Owen Mugurungi, Linda-Gail Bekker
INTRODUCTION: Of the two million new HIV infections in adults in 2014, 70% occurred in sub-Saharan Africa. Several African countries have already approved guidelines for pre-exposure prophylaxis (PrEP) for individuals at substantial risk of HIV as part of combination HIV prevention but key questions remain about how to identify and deliver PrEP to those at greatest need. Throughout the continent, individuals in sero-discordant relationships, and members of key populations (sex workers, men who have sex with men (MSM), transgender women and injection drug users) are likely to benefit from the availability of PrEP...
2016: Journal of the International AIDS Society
Qingyan Ma, Lai Sze Tso, Zachary C Rich, Brian J Hall, Rachel Beanland, Haochu Li, Mellanye Lackey, Fengyu Hu, Weiping Cai, Meg Doherty, Joseph D Tucker
INTRODUCTION: Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. METHODS: We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers...
2016: Journal of the International AIDS Society
Jennifer Jao, Rohan Hazra, Claude A Mellins, Robert H Remien, Elaine J Abrams
INTRODUCTION: The tremendous success of antiretroviral therapy has resulted in a diminishing population of perinatally HIV-infected children on the one hand and a mounting number of HIV-exposed uninfected (HEU) children on the other. As the oldest of these HEU children are reaching adolescence, questions have emerged surrounding the implications of HEU status disclosure to these adolescents. This article outlines the arguments for and against disclosure of a child's HEU status. DISCUSSION: Disclosure of a child's HEU status, by definition, requires disclosure of maternal HIV status...
2016: Journal of the International AIDS Society
Douglas S Krakower, Kevin M Maloney, Chris Grasso, Katherine Melbourne, Kenneth H Mayer
INTRODUCTION: An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists...
2016: Journal of the International AIDS Society
Carole Ian McAteer, Nhan-Ai Thi Truong, Josephine Aluoch, Andrew Roland Deathe, Winstone M Nyandiko, Irene Marete, Rachel Christine Vreeman
INTRODUCTION: HIV-related stigma impacts the quality of life and care management of HIV-infected and HIV-affected individuals, but how we measure stigma and its impact on children and adolescents has less often been described. METHODS: We conducted a systematic review of studies that measured HIV-related stigma with a quantitative tool in paediatric HIV-infected and HIV-affected populations. RESULTS AND DISCUSSION: Varying measures have been used to assess stigma in paediatric populations, with most studies utilizing the full or variant form of the HIV Stigma Scale that has been validated in adult populations and utilized with paediatric populations in Africa, Asia and the United States...
2016: Journal of the International AIDS Society
Richard G Parker, Amaya Perez-Brumer, Jonathan Garcia, Kelly Gavigan, Ana Ramirez, Jack Milnor, Veriano Terto
INTRODUCTION: Critical technological advances have yielded a toolkit of HIV prevention strategies. This literature review sought to provide contextual and historical reflection needed to bridge the conceptual gap between clinical efficacy and community effectiveness (i.e. knowledge and usage) of existing HIV prevention options, especially in resource-poor settings. METHODS: Between January 2015 and October 2015, we reviewed scholarly and grey literatures to define treatment literacy and health literacy and assess the current need for literacy related to HIV prevention...
2016: Journal of the International AIDS Society
Steven A Safren, James P Hughes, Matthew J Mimiaga, Ayana T Moore, Ruth Khalili Friedman, Kriengkrai Srithanaviboonchai, Mohammed Limbada, Brian D Williamson, Vanessa Elharrar, Vanessa Cummings, Jessica F Magidson, Charlotte A Gaydos, David D Celentano, Kenneth H Mayer
INTRODUCTION: Successful global treatment as prevention (TasP) requires identifying HIV-positive individuals at high risk for transmitting HIV, and having impact via potential infections averted. This study estimated the frequency and predictors of numbers of HIV transmissions and bacterial sexually transmitted infection (STI) acquisition among sexually active HIV-positive individuals in care from three representative global settings. METHODS: HIV-positive individuals (n=749), including heterosexual men, heterosexual women and men who have sex with men (MSM) in HIV care, were recruited from Chiang Mai (Thailand), Rio De Janeiro (Brazil) and Lusaka (Zambia)...
2016: Journal of the International AIDS Society
Julia K Rohr, Prudence Ive, C Robert Horsburgh, Rebecca Berhanu, Kate Shearer, Mhairi Maskew, Lawrence Long, Ian Sanne, Jean Bassett, Osman Ebrahim, Matthew P Fox
INTRODUCTION: A substantial number of patients with HIV in South Africa have failed first-line antiretroviral therapy (ART). Although individual predictors of first-line ART failure have been identified, few studies in resource-limited settings have been large enough for predictive modelling. Understanding the absolute risk of first-line failure is useful for patient monitoring and for effectively targeting limited resources for second-line ART. We developed a predictive model to identify patients at the greatest risk of virologic failure on first-line ART, and to estimate the proportion of patients needing second-line ART over five years on treatment...
2016: Journal of the International AIDS Society
Derek R MacFadden, Darrell H Tan, Sharmistha Mishra
INTRODUCTION: Once-daily tenofovir/emtricitabine-based pre-exposure prophylaxis (PrEP) can reduce HIV acquisition in men who have sex with men (MSM), by 44% in the iPrEx trial, and reaching up to 99% with high adherence. We examined the potential population-level impact and cost-effectiveness of different PrEP implementation strategies. METHODS: We developed a dynamic, stochastic compartmental model of HIV transmission among the estimated 57,400 MSM in Toronto, Canada...
2016: Journal of the International AIDS Society
Richard H Beigi, Lisa M Noguchi, Elizabeth Montgomery, Joseph Biggio, Craig W Hendrix, Mark A Marzinke, James Y Dai, Jason Pan, Ratiya Kunjara Na Ayudhya, Jill L Schwartz, Karen Isaacs, Jeanna M Piper, D Heather Watts
INTRODUCTION: Vaginal tenofovir (TFV) 1% gel may reduce incident HIV-1 and herpes simplex virus 2 infection. Pregnancy may increase risk of HIV acquisition, and incident HIV in pregnancy potentiates perinatal HIV transmission. Our objective was to investigate the safety and pharmacokinetics of seven days of TFV 1% vaginal gel in term and near-term pregnancy. METHODS: Ninety-eight healthy pregnant women, stratified to a term cohort followed by a near-term cohort, were enrolled into a 2:1 randomized, double-blinded, placebo-controlled trial...
2016: Journal of the International AIDS Society
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