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hiv prophylaxis preexposure

T K Kamble, Pradyumna M Gadewar, Subodh Kansal
HIV/AIDS continues to have an extraordinary public health impact. Although the HIV/AIDS epidemic on the whole is plateauing, it is spreading rapidly among certain populations. We enumerate here some HIV preventive modalities that have been demonstrated to be effective in various target populations if properly implemented and adhered to. Some other new strategies are also showing promise in clinical trials.
April 2016: Journal of the Association of Physicians of India
James Conniff
A transformation in legal and cultural attitudes toward same-sex relationships is under way nationwide. As same-sex marriage has become legal, the unique social and medicolegal issues faced by individuals in same-sex relationships are evolving rapidly. National organizations have published recommendations for making clinical environments more inclusive of lesbian, gay, bisexual, and queer (LGBQ) individuals and their families. Medical issues for patients in same-sex relationships include a higher risk of HIV infection for men who have sex with men (a majority of new cases of HIV infection occur within relationships), higher rates of obesity among women who have sex with women, and disproportionately high rates of mental health issues and alcohol and drug use...
October 2016: FP Essentials
Renata Arrington-Sanders, Anthony Morgan, Jessica Oidtman, Ian Qian, David Celentano, Chris Beyrer
PURPOSE: HIV disproportionately impacts young black men who have sex with men (YBMSM). Preexposure prophylaxis (PrEP) is an effective strategy that can avert new HIV infections in YBMSM. Barriers exist for YBMSM to access PrEP. METHODS: We sought to determine factors associated with awareness of and willingness to take PrEP in a sample of YBMSM. RESULTS: Only 8% were currently on PrEP despite many (66%) reporting condomless anal sex, a recent provider visit (54%), disclosing their sexual orientation to their regular medical provider (62%), or a willingness to take PrEP (62%)...
October 5, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Dawn K Smith, Emily Maier, Joshua Betts, Simone Gray, Brian Kolodziejski, Karen W Hoover
Community-based organizations (CBOs) are critical to delivery of effective HIV prevention because of their reach to key populations. This online survey of a national sample of CBOs assessed their awareness of, interest in, and resources needed to provide nonoccupational postexposure prophylaxis (nPEP), preexposure prophylaxis (PrEP), and HIV treatment as prevention (TasP). One hundred seventy-five CBOs participated: 87 clinical and 88 nonclinical CBOs. For nPEP, PrEP, and TasP, program managers reported that awareness was high (94%, 90%, 85%), meeting current client need was low (20%, 13%, 18%), and the likelihood of increasing their current provision with additional resources was somewhat high (62%, 64%, 62%)...
October 2016: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Julia L Marcus, Leo B Hurley, C Bradley Hare, Michael J Silverberg, Jonathan E Volk
No abstract text is available yet for this article.
October 2016: American Journal of Public Health
Elizabeth J Unni, Nadia Lian, William Kuykendall
OBJECTIVES: Preexposure prophylaxis (PrEP) therapy is prescribed to HIV-negative individuals who are at high risk of contracting the virus to reduce the risk of transmission. Adherence to therapy is essential for optimal treatment outcome, and community pharmacists have an important role in achieving this through patient counseling. The objectives of this study were to measure pharmacists' actual knowledge about HIV PrEP therapy, perceptions about their HIV PrEP therapy knowledge, and intention to counsel patients about PrEP therapy...
September 2016: Journal of the American Pharmacists Association: JAPhA
G Dubourg, D Raoult
Preexposure prophylaxis (PrEP) against HIV is currently the subject of great interest, as clinical trials have shown high efficacy in terms of decreasing transmission among men who have sex with men. Because the prevalence of bacterial sexual transmitted infections (STIs) is increasing within this community, a recent pilot study demonstrated the efficacy of reducing transmission of bacterial STIs by administering PrEP with daily doxycycline to men who have sex with men. This creative initiative raises several questions which are discussed in this review...
September 2016: Clinical Microbiology and Infection
Susanne Doblecki-Lewis, Deborah Jones
Preexposure prophylaxis (PrEP) for HIV has the potential to reduce HIV incidence in highly affected areas. The Southeastern United States is disproportionately impacted by HIV, and 3 counties in South Florida have the highest incidence of new HIV infections in the United States. This study explored the feasibility, acceptability, and uptake of PrEP in South Florida. Focus groups consisting of providers, administrators, and case managers at HIV-servicing community health centers and federally qualified health centers in South Florida reported broad support but low implementation of PrEP...
August 7, 2016: Journal of the International Association of Providers of AIDS Care
Dominika L Seidman, Shannon Weber, Maria Teresa Timoney, Karishma K Oza, Elizabeth Mullins, Deborah L Cohan, Rodney L Wright
BACKGROUND: Pregnancy may increase a woman's susceptibility to HIV. Maternal HIV acquisition during pregnancy and lactation is associated with increased perinatal and lactational HIV transmission. There are no published reports of preexposure prophylaxis use after the first trimester of pregnancy or during lactation. OBJECTIVE: The purpose of this study was to report the use of preexposure prophylaxis and to identify gaps in HIV prevention services for women who were at substantial risk of HIV preconception and during pregnancy and lactation at 2 United States medical centers...
July 19, 2016: American Journal of Obstetrics and Gynecology
S Duwal, V Sunkara, M von Kleist
While HIV-1 continues to spread, the use of antivirals in preexposure prophylaxis (PrEP) has recently been suggested. Here we present a modular systems pharmacology modeling pipeline, predicting PrEP efficacy of nucleotide reverse transcriptase inhibitors (NRTIs) at the scale of reverse transcription, target-cell, and systemic infection and after repeated viral exposures, akin to clinical trials. We use this pipeline to benchmark the prophylactic efficacy of all currently approved NRTIs in wildtype and mutant viruses...
July 2016: CPT: Pharmacometrics & Systems Pharmacology
Peter L Anderson, Daniel Reirden, Jose Castillo-Mancilla
Studies of tenofovir disoproxil fumarate (TDF)-emtricitabine (FTC)-based preexposure prophylaxis (PrEP) have not focused on transgendered women who are at disproportionate risk of HIV acquisition. Concerns exist for drug interactions between cross-sex therapy (estradiol, progestins, and spironolactone) with tenofovir disoproxil fumarate-emtricitabine. This review assessed the experimental and theoretical risk for such drug interactions. It was found that none of these medications are implicated as major perpetrators of drug interactions, and the classes use different metabolic pathways for clearance, suggesting a low likelihood for interactions in either direction...
August 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Jared M Baeten
No abstract text is available yet for this article.
July 14, 2016: Journal of Infectious Diseases
Samuel M Jenness, Steven M Goodreau, Eli Rosenberg, Emily N Beylerian, Karen W Hoover, Dawn K Smith, Patrick Sullivan
BACKGROUND:  Preexposure prophylaxis (PrEP) is effective for preventing human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) within trial settings. Population impact will depend on clinical indications for PrEP initiation, coverage levels, and drug adherence. No modeling studies have estimated the impact of clinical practice guidelines for PrEP issued by the Centers for Disease Control and Prevention (CDC). METHODS:  Mathematical models of HIV transmission among MSM were used to estimate the percentage of infections averted (PIA) and the number needed to treat (NNT) under behavioral indications of the CDC's PrEP guidelines...
July 14, 2016: Journal of Infectious Diseases
James Riddell, Jonathan A Cohn
No abstract text is available yet for this article.
July 12, 2016: JAMA: the Journal of the American Medical Association
Huldrych F Günthard, Michael S Saag, Constance A Benson, Carlos del Rio, Joseph J Eron, Joel E Gallant, Jennifer F Hoy, Michael J Mugavero, Paul E Sax, Melanie A Thompson, Rajesh T Gandhi, Raphael J Landovitz, Davey M Smith, Donna M Jacobsen, Paul A Volberding
IMPORTANCE: New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults. OBJECTIVE: To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis...
July 12, 2016: JAMA: the Journal of the American Medical Association
Susan P Buchbinder, Albert Y Liu
The 2016 Conference on Retroviruses and Opportunistic Infections (CROI) highlighted hot spots in HIV infection. Men who have sex with men (MSM), transgender populations, people who inject drugs, fisherfolk, migrants, adolescents, and older adults are heavily impacted in a number of regions. Stigma contributes to risk behaviors and HIV acquisition across populations. HIV testing is a crucial first step in the HIV care continuum, and several large community-based surveys are underway in Africa to increase HIV testing, linkage to care, and uptake of antiretroviral treatment...
May 2016: Topics in Antiviral Medicine
Jonathan M Snowden, Maria I Rodriguez, Skyler D Jackson, Julia L Marcus
Preexposure prophylaxis has transformed HIV prevention, becoming widespread in communities of gay and bisexual men in the developed world in a short time. There is a broad concern that preexposure prophylaxis will discourage condom use among gay men (i.e., "risk compensation"). This commentary argues for broadening the focus on gay men's health beyond sexual health to address the holistic health and well-being of gay men. Gay men may benefit from being offered candid, nonjudgmental health promotion/HIV prevention messages not requiring condom use for anal sex...
September 2016: American Journal of Men's Health
Priya Srinivasan, John A Moss, Manjula Gunawardana, Scott A Churchman, Flora Yang, Chuong T Dinh, James M Mitchell, Jining Zhang, Rob Fanter, Christine S Miller, Irina Butkyavichene, Janet M McNicholl, Thomas J Smith, Marc M Baum, James M Smith
Topical preexposure prophylaxis (PrEP) against HIV has been marginally successful in recent clinical trials with low adherence rates being a primary factor for failure. Controlled, sustained release of antiretroviral (ARV) drugs may help overcome these low adherence rates if the product is protective for extended periods of time. The oral combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is currently the only FDA-approved ARV drug for HIV PrEP. A novel pod-intravaginal ring (IVR) delivering TDF and FTC at independently controlled rates was evaluated for efficacy at preventing SHIV162p3 infection in a rigorous, repeat low-dose vaginal exposure model using normally cycling female pigtailed macaques...
2016: PloS One
Amrita Rao, Stefan Baral, Nancy Phaswana-Mafuya, Andrew Lambert, Zamakayise Kose, Mfezi Mcingana, Claire Holland, Sosthenes Ketende, Sheree Schwartz
OBJECTIVE: To assess the association between human immunodeficiency virus (HIV) and pregnancy intentions and safer conception knowledge among female sex workers in Port Elizabeth, South Africa. METHODS: This cross-sectional study recruited female sex workers in Port Elizabeth using respondent-driven sampling and completed an interviewer-administered questionnaire alongside HIV testing and counseling. In this secondary analysis, robust Poisson regression was used to model prevalence ratios for positive fertility intentions in this cross-sectional study...
July 2016: Obstetrics and Gynecology
Dominika Seidman, Shannon Weber
Women comprise one in five new human immunodeficiency virus (HIV) diagnoses in the United States. Trials and implementation projects demonstrate preexposure prophylaxis for HIV prevention is effective in women. Preexposure prophylaxis is a method of preventing HIV acquisition by having an HIV-negative individual take antiretroviral medication before exposure. The U.S. Food and Drug Administration approved daily oral tenofovir disoproxil fumarate coformulated with emtricitabine as preexposure prophylaxis for HIV prevention in 2012...
July 2016: Obstetrics and Gynecology
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