+ Translate

Combination prevention: new hope for stopping the epidemic

, : Combination prevention: new hope for stopping the epidemic. Current Hiv/Aids Reports 10(2): 169-186

HIV research has identified approaches that can be combined to be more effective in transmission reduction than any 1 modality alone: delayed adolescent sexual debut, mutual monogamy or sexual partner reduction, correct and consistent condom use, pre-exposure prophylaxis with oral antiretroviral drugs or vaginal microbicides, voluntary medical male circumcision, antiretroviral therapy (ART) for prevention (including prevention of mother to child HIV transmission [PMTCT]), treatment of sexually transmitted infections, use of clean needles for all injections, blood screening prior to donation, a future HIV prime/boost vaccine, and the female condom. The extent to which evidence-based modalities can be combined to prevent substantial HIV transmission is largely unknown, but combination approaches that are truly implementable in field conditions are likely to be far more effective than single interventions alone. Analogous to PMTCT, "treatment as prevention" for adult-to-adult transmission reduction includes expanded HIV testing, linkage to care, antiretroviral coverage, retention in care, adherence to therapy, and management of key co-morbidities such as depression and substance use. With successful viral suppression, persons with HIV are far less infectious to others, as we see in the fields of sexually transmitted infection control and mycobacterial disease control (tuberculosis and leprosy). Combination approaches are complex, may involve high program costs, and require substantial global commitments. We present a rationale for such investments and cite an ongoing research agenda that seeks to determine how feasible and cost-effective a combination prevention approach would be in a variety of epidemic contexts, notably that in a sub-Saharan Africa.

(PDF same-day service: $19.90)

Accession: 036788291

PMID: 23456730

DOI: 10.1007/s11904-013-0155-y

Submit PDF Full Text: Here

Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:

Related references

Luft, F.C., 2000: STOPPING at the CAPPP of good HOPE. Nephrology, Dialysis, Transplantation 15(4): 451-452

Abuelezam, N.N.; McCormick, A.W.; Fussell, T.; Afriyie, A.N.; Wood, R.; DeGruttola, V.; Freedberg, K.A.; Lipsitch, M.; Seage, G.R., 2016: Can the Heterosexual HIV Epidemic be Eliminated in South Africa Using Combination Prevention? A Modeling Analysis. Little is known about how combining efficacious interventions for human immunodeficiency virus (HIV) prevention could lead to HIV elimination. We used an agent-based simulation model, the HIV calibrated dynamic model, to assess the potential for H...

Naper, J., 1994: Behavior change: best hope for stopping the spread of AIDS. Hospital Technology Series 13(15): 3-5

Schiffrin, E.L., 2000: HOPE gives reason for hope. Heart Outcomes Prevention Evaluation. Current Hypertension Reports 2(1): 59-61

Conaghan, P.G.; Proudman, S.; Brown, C.; Emery, P., 1998: Combination therapy for poor prognosis rheumatoid arthritis Effects of stopping cyclosporin A after 2 years of combination with methotrexate. Arthritis & Rheumatism 41(9 SUPPL ): S60, Sept

Valadie, L., 2005: Stopping the epidemic: what more can you do?. Emergency Medical Services 34(5): 24-24

Kawata, P., 1987: Stopping the AIDS epidemic. Public Welfare 44(3): 35-35

Getahun, H.; Varma, J., 2016: Transitioning from 'stopping' to 'ending' the tuberculosis epidemic. International Journal of Tuberculosis and Lung Disease 19(6): 623-624

Anonymous, 2001: African-Americans see little progress in stopping epidemic. A new study commissioned by the Kaiser Family Foundation shows that African-Americans are twice as worried about the HIV epidemic as Americans overall, and that they are not satisfied with government efforts to curb the infection rate. The survey,...

Hutt, D., 1994: Stopping an epidemic of Clostridium difficile diarrhea. Annals of Internal Medicine 121(4): 307-307