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Biomedical hiv prevention

Philippe A Gallay, Udayan Chatterji, Aaron Kirchhoff, Angel Gandarilla, Richard B Pyles, Marc M Baum, John A Moss
Introduction: In the absence of a vaccine, there is an urgent need for the identification of effective agents that prevent HIV transmission in uninfected individuals. Non-vaccine Biomedical Prevention (nBP) methods, such as topical or systemic pre-exposure prophylaxis (PrEP), are promising strategies to slow down the spread of AIDS. Methods: In this study, we investigated the microbicidal efficacy of the viral membrane-disrupting amphipathic SWLRDIWDWICEVLSDFK peptide called C5A...
2018: Open Virology Journal
Dean G Cruess, Kaylee E Burnham, David J Finitsis, Brett M Goshe, Lauren Strainge, Moira Kalichman, Tamar Grebler, Chauncey Cherry, Seth C Kalichman
Background: HIV disproportionately affects sexual minority men, and developing strategies to reduce transmission risk is a public health priority. Purpose: The goal was to empirically test a newly developed, Information, Motivation, Behavioral skills (IMB) theoretically derived, online HIV sexual risk reduction intervention (called HINTS) among a sample of sexual minority men living with HIV. Methods: Participants were 167 men randomized to either the four-session online HINTS intervention or to a time-matched, online control condition...
February 5, 2018: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Audrey Pettifor, Marie Stoner, Carey Pike, Linda-Gail Bekker
PURPOSE OF REVIEW: Many of the almost 2 million HIV infections that occurred globally in the last year occurred among adolescents and young people, particularly those from East and Southern Africa and within key populations. Global HIV epidemic control will require that new infections among these youth populations be curtailed. This review examines the most effective prevention approaches to reach these adolescent populations in the next 5 years. RECENT FINDINGS: Adolescents are in transition and are developmentally unique...
March 9, 2018: Current Opinion in HIV and AIDS
Jody Boffa, Maria Mayan, Sithembile Ndlovu, Tsholofelo Mhlaba, Tyler Williamson, Reginald Sauve, Dina Fisher
INTRODUCTION: In response to revisions in global and national policy in 2011, six-month isoniazid preventive therapy (IPT) became freely available as a preventive measure for people living with HIV in the uMgungundlovu District of KwaZulu-Natal province, South Africa. Given a difference in uptake and completion by sex, we sought to explore the reasons why Zulu women were more likely to accept and complete IPT compared to men in an effort to inform future implementation. METHODS: Utilising a community-based participatory research approach and ethnographic methods, we undertook 17 individual and group interviews, and met regularly with grassroots community advisory teams in three Zulu communities located in uMgungundlovu District between March 2012-December 2016...
2018: PloS One
Bruna de Paula Fonseca E Fonseca, Priscila Costa Albuquerque, Ed Noyons, Fabio Zicker
BACKGROUND: South-south collaboration on health and development research is a critical mechanism for social and economic progress. It allows sharing and replicating experiences to find a "southern solution" to meet shared health challenges, such as access to adequate HIV/AIDS prevention and treatment. This study aimed to generate evidence on the dynamics of south-south collaboration in HIV/AIDS research, which could ultimately inform stakeholders on the progress and nature of collaboration towards increased research capacities in low- and middle-income countries (LMIC)...
March 1, 2018: Globalization and Health
Xilin Wu, Jia Guo, Mengyue Niu, Minghui An, Li Liu, Hui Wang, Xia Jin, Qi Zhang, Ka Shing Lam, Tongjin Wu, Hua Wang, Qian Wang, Yanhua Du, Jingjing Li, Lin Cheng, Hang Ying Tang, Hong Shang, Linqi Zhang, Paul Zhou, Zhiwei Chen
The discovery of an HIV-1 cure remains a medical challenge because the virus rebounds quickly after the cessation of combination antiretroviral drug therapy (cART). Here, we investigate the potential of an engineered tandem bi-specific broadly neutralizing antibody (bs-bnAb) as an innovative product for HIV-1 prophylactic and therapeutic interventions. We discovered that by preserving two scFv binding domains of each parental bnAb, a single-gene-encoded tandem bs-bnAb, namely BiIA-SG, displayed significantly improved breadth and potency...
February 20, 2018: Journal of Clinical Investigation
Robert Walter Eisinger, Anthony S Fauci
The goal of ending the HIV/AIDS pandemic is theoretically achievable and would require addressing this global health catastrophe on individual and global levels by providing optimal prevention strategies and treatment regimens for individual persons living with or at risk for HIV, as well as ending the pandemic as an epidemiologic and global health phenomenon. However, from a practical standpoint, the pathway to ending the HIV/AIDS pandemic will be difficult and will require aggressive implementation of the biomedical research advances that have been made in the areas of treatment and prevention; development of additional tools, such as a moderately effective HIV vaccine; and attention to critical behavioral and social determinants...
March 2018: Emerging Infectious Diseases
Raymond B T Lim, Olive N Y Cheung, Bee Choo Tai, Mark I-C Chen, Roy K W Chan, Mee Lian Wong
OBJECTIVES: We assessed the efficacy of a multicomponent culturally tailored HIV/STI prevention intervention programme on consistent condom use and STI incidence among foreign Thai and Vietnamese female entertainment workers (FEWs) in Singapore. METHODS: We conducted a quasi-experimental pretest and post-test intervention trial with a comparison group. We recruited 220 participants (115 Vietnamese and 105 Thai) for the comparison group, followed by the intervention group (same number) from the same sites which were purposively selected after a 3-month interval period...
February 14, 2018: Sexually Transmitted Infections
Millicent Atujuna, Peter A Newman, Melissa Wallace, Megan Eluhu, Clara Rubincam, Ben Brown, Linda-Gail Bekker
BACKGROUND: New biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships. METHODS: We conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers...
2018: PloS One
Jonathan Stadler, Hayley MacGregor, Eirik Saethre, Sinead Delany-Moretlwe
During a five-day workshop, former clinical trial participants and local musicians wrote the lyrics and recorded a song about an HIV prevention trial. Born of concerns about misconceptions regarding experimental drug trials, the aim was to engender engagement with medical researchers and open dialogue about the risks and benefits of trial participation. Composing lyrics that highlighted their credibility as communicators of medical scientific knowledge and their selfless sacrifice to stem the transmission of HIV, women performed their social positioning and cultural authority in contrast to men as well as other women not part of the trial...
February 8, 2018: Culture, Health & Sexuality
Bernadette Hensen, James R Hargreaves, Tarisai Chiyaka, Sungai Chabata, Phillis Mushati, Sian Floyd, Isolde Birdthistle, Joanna Busza, Frances Cowan
BACKGROUND: "Determined, Resilient, AIDS-free, Mentored and Safe" (DREAMS) is a package of biomedical, social and economic interventions offered to adolescent girls and young women aged 10-24 years with the aim of reducing HIV incidence. In four of the six DREAMS districts in Zimbabwe, DREAMS includes an offer of oral pre-exposure prophylaxis (DREAMS+PrEP), alongside interventions to support demand and adherence, to women aged 18-24 who are at highest risk of HIV infection, including young women who sell sex (YWSS)...
January 31, 2018: BMC Public Health
Matthew Thomann
The global scale-up of AIDS treatment initiatives during the first decade of the twenty-first century has been referred to as a kind of 'pharmaceuticalisation' of public health, a trend that is now building in the area of HIV prevention. This paper traces the emergence and increased uptake of pre-exposure prophylaxis (PrEP), antiretroviral medications that can keep HIV negative individuals from becoming infected, placing it within the broader (re)casting of HIV prevention as a medical and technological problem that has been central to the recent 'end of AIDS' discourse...
January 25, 2018: Global Public Health
Ran Van der Wal, David Loutfi
Pre-exposure prophylaxis (PrEP) has proven to be highly effective in preventing HIV in uninfected persons when properly adhered to. East and Southern African countries that suffer from high HIV prevalence and incidence are increasingly adopting PrEP as an HIV prevention strategy for their high-risk populations, including for young women. Structural factors such as poverty, lack of education, and gender-based violence may compromise their PrEP uptake and adherence, however. Choice-disabled young women are most at risk of HIV infection and least able to apply HIV prevention choices...
January 22, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
M Reuel Friedman, Jordan M Sang, Leigh A Bukowski, Derrick D Matthews, Lisa A Eaton, H Fisher Raymond, Ron Stall
INTRODUCTION: Differences across the HIV care continuum between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO) are emerging in recent literature but have not been comprehensively documented among Black MSM. Although MSMW have lower HIV prevalence than MSMO, they are more likely to be HIV-positive unaware and be virally unsuppressed. Explanatory factors for these differences have not previously been assessed. METHODS: Between 2014-2016, we surveyed sexually active Black MSM ≥18 years old at Black Gay Pride events in six U...
January 15, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Thurka Sangaramoorthy
In biomedical, public health, and popular discourses, the 'end of AIDS' has emerged as a predominant way to understand the future of HIV research and prevention. This approach is predicated on structuring and responding to HIV in ways that underscore its presumed lifelong nature. In this article, I examine the phenomenon of HIV chronicity that undergirds the 'end of AIDS' discourse. In particular, I explore how the logic of HIV chronicity, induced by technological advances in treatment and global financial and political investments, intensifies long-term uncertainty and prolonged crisis...
January 11, 2018: Global Public Health
Robyn Eakle, Adam Bourne, Caitlin Jarrett, Jonathan Stadler, Heidi Larson
BACKGROUND: Women bear a disproportionate burden of HIV throughout the world prompting extensive research into HIV prevention products for women which has met with varied success. With an aim of informing future policy and programming, this review examines the barriers and motivations to the uptake and use of female initiated products in sub-Saharan countries. METHODS: We conducted a systematic review as an adapted meta-ethnography of qualitative data focused on actual use of products...
December 19, 2017: BMC Public Health
Ronald S Veazey, Andrew A Lackner
Research using nonhuman primates (NHPs) as models for human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has resulted in tremendous achievements not only in the prevention and treatment of HIV, but also in biomedical research more broadly. Once considered a death sentence, HIV infection is now fairly well controlled with combination antiretroviral treatments, almost all of which were first tested for efficacy and safety in nonhuman primates or other laboratory animals...
December 1, 2017: ILAR Journal
Kristi E Gamarel, Kimberly M Nelson, Rob Stephenson, Olga J Santiago Rivera, Danielle Chiaramonte, Robin Lin Miller
Young gay, bisexual and other men who have sex with men (YGBMSM) and young transgender women are disproportionately affected by HIV/AIDS. The success of biomedical prevention strategies is predicated on regular HIV testing; however, there has been limited uptake of testing among YGBMSM and young transgender women. Anticipated HIV stigma-expecting rejection as a result of seroconversion- may serve as a significant barrier to testing. A cross-sectional sample of YGBMSM (n = 719, 95.5%) and young transgender women (n = 33, 4...
February 2018: AIDS and Behavior
Alyssa Ferguson, Kate Shannon, Jennifer Butler, Shira M Goldenberg
Background: While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally...
2017: Conflict and Health
Daniel Wood, Kathryn E Lancaster, Marie-Claude Boily, Kimberly A Powers, Deborah Donnell, Myron S Cohen, Dobromir T Dimitrov
BACKGROUND/SETTING: Randomized controlled trials (RCTs) of HIV biomedical prevention interventions often enroll participants with varying levels of HIV exposure, including people never exposed to HIV. We assessed whether enrolling larger proportion of participants with consistently high exposure to HIV, such as female sex workers (FSWs), might reduce trial duration and improve the accuracy of product efficacy estimates in future HIV prevention trials. METHODS: We used an individual-based stochastic model to simulate event-driven RCTs of an HIV prevention intervention providing 80% reduction in susceptibility per act under different proportions of FSW enrolled...
April 1, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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