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Biomedical hiv prevention

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
Matthew J Mimiaga, Elizabeth F Closson, Shanice Battle, Jeffrey H Herbst, Damian Denson, Nicole Pitts, Jeremy Holman, Stewart Landers, Gordon Mansergh
Men who have sex with men (MSM) of color are disproportionately affected by HIV in the United States. Pre-exposure prophylaxis (PrEP) using antiretroviral medications is a newer biomedical prevention modality with established efficacy for reducing the risk of acquiring HIV. We conducted formative qualitative research to explore audience reactions and receptivity to message concepts on PrEP as part of the development of prevention messages to promote PrEP awareness among black and Latino MSM in the United States...
October 2016: AIDS Patient Care and STDs
Jeremy Sugarman, Damon M Seils, J Kemp Watson-Ormond, Kevin P Weinfurt
BACKGROUND: We describe our use of cognitive interviews in developing a measure of "preventive misconception" to demonstrate the importance of this approach to researchers developing surveys in empirical bioethics. The preventive misconception involves research participants' false beliefs about a prevention trial, including beliefs that the interventions being tested will certainly be effective. METHODS: We developed and refined a measure of the preventive misconception using qualitative interviews that focused on cognitive testing of proposed survey items with HIV prevention trial participants...
2016: AJOB Empirical Bioethics
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
Bonaventura C T Mpondo
Sexually transmitted infections remain to be of public health concern in many developing countries. Their control is important, considering the high incidence of acute infections, complications and sequelae, and their socioeconomic impact. This article discusses the new biomedical technologies and strategies for the prevention of HIV and other sexually transmitted infections.
2016: Journal of Sexually Transmitted Diseases
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
Janet M McNicholl
Biomedical preventions for HIV, such as vaccines, microbicides or pre-exposure prophylaxis (PrEP) with antiretroviral drugs, can each only partially prevent HIV-1 infection in most human trials. Oral PrEP is now FDA approved for HIV-prevention in high risk groups, but partial adherence reduces efficacy. If combined as biomedical preventions (CBP) an HIV vaccine could provide protection when PrEP adherence is low and PrEP could prevent vaccine breakthroughs. Other types of PrEP or microbicides may also be partially protective...
September 28, 2016: Human Vaccines & Immunotherapeutics
J M Hugo, R D Stall, K Rebe, J E Egan, G De Swardt, H Struthers, J A McIntyre
Men who have Sex with Men (MSM) have been affected disproportionately by the global HIV pandemic. Rates of consistent condom-use are low and there is a need for further biomedical prevention interventions to prevent new HIV infections. Post exposure prophylaxis (PEP) can reduce the risk of HIV, but uptake among MSM is low. Pre-exposure prophylaxis (PrEP), an innovative anti-retroviral-based HIV prevention tool might be an appropriate intervention for MSM who have recently accessed PEP that involves HIV negative individuals taking daily tenofovir+emtricitabine for HIV prevention...
September 8, 2016: AIDS and Behavior
Daniel Werb, Richard Garfein, Thomas Kerr, Peter Davidson, Perrine Roux, Marie Jauffret-Roustide, Marc Auriacombe, Will Small, Steffanie A Strathdee
BACKGROUND: Injection drug use remains a primary driver of HIV and HCV-related harms globally. However, there is a gap in efforts to prevent individuals from transitioning into injecting. People who inject drugs (PWID) play a key role in the transition of others into injecting, and while behavioral interventions have been developed to address this phenomenon, socio-structural approaches remain unexplored. To that end, we hypothesize that certain interventions designed to reduce injecting-related risk behaviors may also reduce the risk that PWID expose and introduce others into injecting...
2016: Harm Reduction Journal
Alexandra Machado, Cassilda Cunha-Reis, Francisca Araújo, Rute Nunes, Vítor Seabra, Domingos Ferreira, José das Neves, Bruno Sarmento
UNLABELLED: Topical pre-exposure prophylaxis (PrEP) with antiretroviral drugs holds promise in preventing vaginal transmission of HIV. However, significant biomedical and social issues found in multiple past clinical trials still need to be addressed in order to optimize protection and users' adherence. One approach may be the development of improved microbicide products. A novel delivery platform comprising drug-loaded nanoparticles (NPs) incorporated into a thin polymeric film base (NPs-in-film) was developed in order to allow the vaginal administration of the microbicide drug candidate tenofovir...
October 15, 2016: Acta Biomaterialia
J M Hugo, R D Stall, K Rebe, J E Egan, G Jobson, G De Swardt, H Struthers, J A McIntyre
The Soweto Men's Study (2008), demonstrated an overall HIV prevalence rate of 13.2 %, with 10.1 % among straight-identified Men-who-have-sex-with-men (MSM), 6.4 % among bisexual-identified MSM and 33.9 % among gay-identified MSM. Behavioral interventions are imperative, but insufficient to prevent new HIV infections. Biomedical prevention of HIV offers a variety of combination prevention tools, including Post-exposure prophylaxis (PEP). PEP studies amongst MSM have been conducted in Amsterdam, Brazil and San Francisco, but never before in Africa...
August 18, 2016: AIDS and Behavior
Pedro Batista, Sherry Deren, Angela Banfield, Evelyn Silva, Mario Cruz, Preston Garnes, Charles M Cleland, Saurabh Mehandru, Melissa LaMar, Martin Markowitz
Recruitment of people who use drugs (PWUD) for HIV-related research has been undertaken since early in the epidemic. In early studies, recruitment was often performed by outreach workers with familiarity with the target population, who distributed risk reduction materials, and administered the surveys being conducted on drug use and risk behaviors. The evolution of effective treatments for HIV has provided opportunities for PWUD to participate in biobehavioral studies testing the efficacy of medical treatment advances and exploring the underlying biomedical basis for prevention and treatment efforts...
August 2016: AIDS Patient Care and STDs
Jake Rance, Tim Rhodes, Suzanne Fraser, Joanne Bryant, Carla Treloar
Despite the majority of needle-syringe sharing occurring between sexual partners, the intimate partnerships of people who inject drugs have been largely overlooked as key sites of both hepatitis C virus prevention and transmission, and risk management more generally. Drawing on interviews with 34 couples living in inner-city Australia, this article focuses on participants' accounts of 'sharing'. While health promotion discourses and conventional epidemiology have tended to interpret the practice of sharing (like the absence of condom use) in terms of 'noncompliance', we are interested in participants' socially and relationally situated 'rationalities'...
August 3, 2016: Health (London)
Aimee N C Campbell, Don Des Jarlais, Cooper Hannah, Sarah Braunstein, Susan Tross, Laura Kersanske, Christine Borges, Martina Pavlicova, Kevin Jefferson, Howard Newville, Laurel Weaver, Margaret Wolff
BACKGROUND: The intersection of HIV-related health outcomes and problem substance use has been well documented. New York City continues to be a focal point of the U.S. HIV epidemic. In 2011, the NYC Department of Health and Mental Hygiene (NYC DOHMH) issued a recommendation that all HIV infected individuals should be offered antiretroviral therapy (ART) regardless of CD4 cell count or other indicators of disease progression. This policy is based in the concept of "treatment as prevention," in which providing ART to people living with HIV (PLWH) greatly reduces the likelihood of HIV transmission, while also improving individual health...
2016: BMC Health Services Research
Sharon A Riddler, Marla Husnik, Pamina M Gorbach, Lisa Levy, Urvi Parikh, Edward Livant, Arendevi Pather, Bonus Makanani, Felix Muhlanga, Margaret Kasaro, Francis Martinson, Vanessa Elharrar, Jennifer E Balkus
BACKGROUND: As the effect of biomedical prevention interventions on the natural history of HIV-1 infection in participants who seroconvert is unknown, the Microbicide Trials Network (MTN) established a longitudinal study (MTN-015) to monitor virologic, immunological, and clinical outcomes, as well as behavioral changes among women who become HIV-infected during MTN trials. We describe the rationale, study design, implementation, and enrollment of the initial group of participants in the MTN seroconverter cohort...
September 2016: HIV Clinical Trials
Sophia Osawe, Evaezi Okpokoro, Ruth Datiri, Grace Choji, Felicia Okolo, Pam Datong, Alash'le Abimiku
BACKGROUND: HIV/AIDS continues to be a global health problem. With currently no cure, it is critical to get an effective vaccine to add to the arsenal of prevention and treatment tools. HIV Exposed Sero-Negative (HESN) individuals were enrolled and followed for 2 years. METHODS: A prospective observational cohort study to enroll HESN volunteers and their partners was developed with a 2-year follow up. This was a vaccine preparedness study and designed as a Phase IIb trial...
2016: BMC Infectious Diseases
Ximena Salazar, Arón Núnez-Curto, Jana Villayzán, Regina Castillo, Carlos Benites, Patricia Caballero, Carlos F Cáceres
INTRODUCTION: As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a "Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen...
2016: Journal of the International AIDS Society
Eva Vernooij, Mandhla Mehlo, Anita Hardon, Ria Reis
This article explores how notions of the individual and population are evoked in two ongoing HIV treatment as prevention (TasP) implementation studies in Swaziland. By contrasting policy discourses with lived kinship experiences of people living with HIV, we seek to understand how TasP unfolds in the Swazi context. Data collection consisted of eight focus group discussions with people living with HIV who were members of support groups to examine their perspectives about TasP. In addition, 18 key informant interviews were conducted with study team members, national-level policy-makers and NGO representatives involved in the design of health communication messages about TasP in Swaziland...
2016: AIDS Care
Anna Coutsoudis, Brodie Daniels, Eshia Moodley-Govender, Noluthando Ngomane, Linda Zako, Elizabeth Spooner, Photini Kiepiela, Shabashini Reddy, Louise Kuhn, Gita Ramjee
INTRODUCTION: No randomised controlled trial (RCT) has examined the efficacy of cotrimoxazole (CTX) prophylaxis in HIV-exposed uninfected (HEU) infants during the breastfeeding period, in this new era of effective prevention of mother-to-child transmission (PMTCT) prophylaxis. The efficacy of CTX prophylaxis has presently been demonstrated only in HIV-infected children. The absence of proven benefits in HEU breastfed infants associated with infectious diseases justifies an RCT as proposed...
2016: BMJ Open
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