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Journal of HIV and Human Reproduction: Year : 2015, volume : 3, Issue : 2, Page : 47-55
DHS Working Papers No. 125
F1000Research 2019, 8:323 Last updated: 17 MAY 2019
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002514 March 1, 2018
Supplement Article
www.jaids.com J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018
Communicable Disease Control Branch
Communicable Disease Management Protocol – Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), February 2010
WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i...n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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The uneven distribution of HIV risks and burdens across populations is a well-substantiated fact, though seldom publicly acknowledged. Gay men and other men who have sex with men, people who inject drugs, sex workers, and transgender women are 24, 24, 13.5, and 49 times more likely to acquire HIV, ...respectively, than other reproductive aged adults (15 years old and older). Globally, new infections among these key populations account for 45% of all new HIV infections. This figure is likely to be an underestimate, given the intense stigma associated with disclosing and reporting acquisition risks for HIV among gay men, people who use drugs, sex workers, and transgender people. In addition, HIV epidemics in the majority of low- and middle-income countries (90 of 120) have concentrated epidemics among key populations. In countries with more broadly generalized epidemics, risks are still not evenly distributed and key populations still shoulder disease burden that is markedly disproportionate.
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Male circumcision reduces a man’s risk of heterosexual acquisition of HIV by about 60%. This guideline provides an evidence-based recommendation on the use of adult male circumcision devices for HIV prevention in public health programmes in high HIV prevalence, resource-limited settings. It also p...resents key programmatic considerations for the introduction and use of these devices in public health HIV prevention programmes. The primary audiences are policy- and decision-makers, programme managers, health-care providers, donors and implementing agencies.
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This publication provides managers with guidance on how to create basic HIV prevention cascades as a starting point to enhance their ability to monitor and improve their programming and to facilitate comparisons of programme effectiveness across sites.