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Biomedical Prevention: State of the Science

Preexposure prophylaxis (PrEP) and treatment as prevention (TasP) involve the use of antiretroviral (ARV) drugs by human immunodeficiency virus (HIV)-negative and -positive individuals to reduce HIV acquisition and transmission, respectively. Clinical science has delivered a consistently high effect...

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Autores principales: McCormack, Sheena M., Gafos, Mitzy, Desai, Monica, Cohen, Myron S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060254/
https://www.ncbi.nlm.nih.gov/pubmed/24926033
http://dx.doi.org/10.1093/cid/ciu297
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author McCormack, Sheena M.
Gafos, Mitzy
Desai, Monica
Cohen, Myron S.
author_facet McCormack, Sheena M.
Gafos, Mitzy
Desai, Monica
Cohen, Myron S.
author_sort McCormack, Sheena M.
collection PubMed
description Preexposure prophylaxis (PrEP) and treatment as prevention (TasP) involve the use of antiretroviral (ARV) drugs by human immunodeficiency virus (HIV)-negative and -positive individuals to reduce HIV acquisition and transmission, respectively. Clinical science has delivered a consistently high effect size for TasP and a range from 0%–73% reduction in incidence across placebo-controlled PrEP trials. However, the quality of evidence for PrEP compares favorably with evidence for postexposure prophylaxis (PEP). It is clear from treatment programs and PrEP trials that daily adherence presents challenges to a large proportion of the population. Although there are factors associated with inconsistent use (ie, younger age), they do not assist clinicians at the point of care. There are additional provider concerns about PrEP (covering cost of drug and delivery, undermining condom promotion, and facilitating resistant strains) that have delayed widespread acceptance. These issues need to be addressed in order to realize the full public health potential of antiretrovirals.
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spelling pubmed-40602542014-07-01 Biomedical Prevention: State of the Science McCormack, Sheena M. Gafos, Mitzy Desai, Monica Cohen, Myron S. Clin Infect Dis Controlling the HIV Epidemic with Antiretrovirals Preexposure prophylaxis (PrEP) and treatment as prevention (TasP) involve the use of antiretroviral (ARV) drugs by human immunodeficiency virus (HIV)-negative and -positive individuals to reduce HIV acquisition and transmission, respectively. Clinical science has delivered a consistently high effect size for TasP and a range from 0%–73% reduction in incidence across placebo-controlled PrEP trials. However, the quality of evidence for PrEP compares favorably with evidence for postexposure prophylaxis (PEP). It is clear from treatment programs and PrEP trials that daily adherence presents challenges to a large proportion of the population. Although there are factors associated with inconsistent use (ie, younger age), they do not assist clinicians at the point of care. There are additional provider concerns about PrEP (covering cost of drug and delivery, undermining condom promotion, and facilitating resistant strains) that have delayed widespread acceptance. These issues need to be addressed in order to realize the full public health potential of antiretrovirals. Oxford University Press 2014-07-01 /pmc/articles/PMC4060254/ /pubmed/24926033 http://dx.doi.org/10.1093/cid/ciu297 Text en © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Controlling the HIV Epidemic with Antiretrovirals
McCormack, Sheena M.
Gafos, Mitzy
Desai, Monica
Cohen, Myron S.
Biomedical Prevention: State of the Science
title Biomedical Prevention: State of the Science
title_full Biomedical Prevention: State of the Science
title_fullStr Biomedical Prevention: State of the Science
title_full_unstemmed Biomedical Prevention: State of the Science
title_short Biomedical Prevention: State of the Science
title_sort biomedical prevention: state of the science
topic Controlling the HIV Epidemic with Antiretrovirals
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060254/
https://www.ncbi.nlm.nih.gov/pubmed/24926033
http://dx.doi.org/10.1093/cid/ciu297
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