Multipurpose prevention technologies (MPTs) are designed to target HIV prevention as well as an additional indication such as preventing unintended pregnancies or transmission of other sexually transmissible infections (STIs) such as herpes simplex virus (HSV) infection. Delivery strategies under development include sustained release IVRs (27). While a ring with additional indications, such as preventing pregnancy, …
Nonspecific microbicides Surfactants and detergents Microbicides were originally intended to have broad-spectrum activity against all STIs and contain non-drug compounds for over the counter use without a prescription (2). The first generation microbicides were non-specific agents comprising surfactants and detergents that directly inactivate viral and bacterial STIs (28). The nonionic surfactant, nonoxynol-9 (an over the …
1% Tenofovir gel was shown to achieve an overall efficacy of 39% in the CAPRISA 004 study compared to women receiving placebo gel and 54% efficacy in women who had >80% adherence to gel use (65). Since only 54% efficacy in preventing HIV acquisition was achieved in highly adherent women, this suggests that other factors, …
Biological factors that attenuate topical microbicide efficacy Read More »
Shattock RJ, Moore JP. Inhibiting sexual transmission of HIV-1 infection. Nat Rev Microbiol. 2003;1(1):25-34. Shattock RJ, Rosenberg Z. Microbicides: topical prevention against HIV. Cold Spring Harb Perspect Med. 2012;2(2):a007385. Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002(1):CD003255. McGowan I. The development of rectal microbicides for HIV prevention. …
Iryna Zablotska1, John McAllister2 The University of Sydney, Sydney, NSW St. Vincent’s Hospital, Sydney, Darlinghurst, Sydney, NSW Last reviewed: November 2019 Background The HIV epidemic in Australia Australia has a concentrated human immunodeficiency virus (HIV) epidemic. In 2018, sexual contact between men accounted for approximately 70% of new HIV diagnoses; heterosexual exposure contributed 23%, and …
MSM represent the predominant part of the Australian population at most risk of HIV infection. The most effective way to prevent the sexual transmission of HIV and other STIs is to prevent exposure. Condom use and other behavioural methods of risk reduction, such as HIV serosorting, strategic positioning, negotiated safe practices with sexual partners and …
Terminology Treatment as prevention (TasP) refers to the use of antiretroviral drugs to decrease the risk of HIV transmission. When taken consistently, antiretroviral drugs can reduce the HIV viral load in an HIV-infected individual’s blood, semen, vaginal fluid and rectal fluid to a level at which blood tests cannot detect the virus [17]. Such viral …
Terminology Post-exposure prophylaxis (PEP) was one of the first strategies to employ antiretroviral drugs for the prevention of HIV infection. It involves a 28-day course of antiretroviral drugs initiated within 72 hours of a potential high-risk exposure to HIV. [37] The concept of PEP and evidence of its efficacy Animal models showed that within 3-5 …
Terminology WHO defines pre-exposure prophylaxis (PrEP) as the use of oral tenofovir disoproxil fumarate (TDF) or co-formulated TDF/emtricitabine (TDF/FTC) or co-formulated TDF/lamivudine (TDF/3TC) by HIV-negative people to prevent HIV acquisition (FTC and 3TC are considered interchangeable). In 2019, the US Food and Drug Administration approved emtricitabine + tenofovir alafenamide (FTC/TAF or F/TAF, Descovy®) as another …
Biomedical strategies based on the use of antiretroviral drugs are currently front and centre stage of HIV prevention. General practitioners and nurses have a key role in service provision, education, support and innovative research as TasP, PEP and PrEP assume a more prominent role in HIV prevention.