Posted: Jul 30, 2019
Maximizing the impact of HIV prevention technologies in sub-Saharan Africa
There have been substantial gains in the range and efficacy of technologies available for HIV prevention, with voluntary medical male circumcision (VMMC), treatment as prevention, and pre-exposure prophylaxis (PrEP) being added to the existing toolbox of condoms, lubricant, behaviour change, harm reduction, structural interventions and advocacy programmes. These advances led to the optimism of calls to end the AIDS epidemic by 2030 with a target of fewer than 500,000 new cases a year by 2020 and 200,000 by 2030 . However, progress towards these goals is slow with an estimated 1.9 million new infections in 2017 globally, including over a million in sub-Saharan Africa. Although these numbers represent a substantial reduction from the height of the epidemic in the late 1990s, they are well off target despite intensive efforts to promote HIV combination prevention encompassing structural, behavioural and biomedical interventions. The targets were based on modelling which estimated the coverage needed to achieve these reductions, namely meeting 90-90-90 treatment targets, 90% coverage of key populations with combination prevention programmes, 90% reported condom use rates with non-regular partners and 90% male circumcision. However, investment in prevention has been lower than required to achieve this coverage , and results from trials of intensive population “test and treat” approaches show a lower impact than hoped for, with up to 30% reduction in incidence, but with lower engagement and coverage of younger people.
© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. Helen Ward1, Geoffrey P Garnett2, Kenneth H Mayer3, Gina A Dallabetta2
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Posted: Dec 12, 2017
Helping our patients take HIV pre-exposure prophylaxis (PrEP): a systematic review of adherence interventions
Adherence is critical for maximizing the effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV infection. Strategies for promoting adherence to HIV treatment, and their potential application to PrEP adherence, have received considerable attention. However, adherence promotion strategies for prevention medications have not been well characterized and may be more applicable to PrEP. We aimed to identify adherence support interventions that have been effective in other prevention ﬁelds and could be applied in the HIV prevention context to support pill taking among PrEP users.
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JL Marcus,1,2 T Buisker,2 T Horvath,3 KR Amico,4 JD Fuchs,5 SP Buchbinder,6,7 RM Grant1,7 and AY Liu6
1Gladstone Institute of Virology and Immunology, San Francisco, CA, USA, 2Department of Epidemiology, University of California, Berkeley, CA, USA, 3Global Health Sciences, University of California, San Francisco, CA, USA, 4Center for Health, Intervention and Prevention, University of Connecticut, Storrs, CT, USA, 5Center for Learning and Innovation, San Francisco Department of Public Health, San Francisco, CA, USA, 6Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA and 7Department of Medicine, University of California, San Francisco, CA, USA
Posted: Jul 28, 2017
What Does Not Work in Adolescent Sexual and Reproductive Health: A Review of Evidence on Interventions Commonly Accepted as Best Practices
Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people’s access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. For adolescent SRH programs to be effective, we need substantial effort through coordinated and complementary approaches. Unproductive approaches should be abandoned, proven approaches should be implemented with adequate fidelity to those factors that ensure effectiveness, and new approaches should be explored, to include greater attention to prevention science, engagement of the private sector, and expanding access to a wider range of contraceptive methods that respond to adolescents’ needs.
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Posted: Jul 24, 2017
Is There an Association Between Alcohol Consumption and Sexually Transmitted Diseases? A Systematic Review
Objective/Goal: The objective of this study was to conduct a systematic review of published literature on the association between problematic alcohol consumption and sexually transmitted diseases (STDs).
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COOK, R. L. & CLARK, D. B. 2005. Is there an association between alcohol consumption and sexually transmitted diseases? A systematic review. Sexually transmitted diseases, 32, 156-164.
Posted: Jul 24, 2017
Changing patterns of knowledge, reported behaviour and sexually transmitted infections in a South African gold mining community
Background: In 1998, a major HIV intervention project was started in a mining community in Carletonville, South Africa. This included community-based peer education, condom distribution, syndromic management of sexually transmitted infections (STI), and presumptive STI treatment for sex workers.
Objectives: To investigate changes in sexual behaviour and the prevalence of STI before and 2 years after the start of the HIV prevention programme.
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WILLIAMS, B. G., TALJAARD, D., CAMPBELL, C. M., GOUWS, E., NDHLOVU, L., VAN DAM, J., CARAEL, M. & AUVERT, B. 2003. Changing patterns of knowledge, reported behaviour and sexually transmitted infections in a South African gold mining community. AIDS, 17, 2099-2107.