Use of antiretrovirals for HIV prevention: what do we know and what don't we know?
- PMID: 23494772
- PMCID: PMC3644362
- DOI: 10.1007/s11904-013-0157-9
Use of antiretrovirals for HIV prevention: what do we know and what don't we know?
Abstract
Pre-exposure prophylaxis (PrEP), in which HIV uninfected persons with ongoing HIV risk use antiretroviral medications as chemoprophylaxis against sexual HIV acquisition, is a promising new HIV prevention strategy. Proof-of-concept that PrEP, as oral or vaginal topical tenofovir-based products, protects against sexual HIV acquisition has been demonstrated in clinical trials conducted among men who have sex with men and heterosexual men and women. The degree of HIV protection in these trials was strongly related to the level of adherence to PrEP. Many questions are yet unanswered--including how to motivate uptake of and sustain adherence to PrEP for HIV prevention, how much PrEP use is enough to achieve HIV protection, and the potential of "next-generation" PrEP agents to improve on this effective technology.
Conflict of interest statement
Jared Baeten declares that he has no conflict of interest.
Robert Grant declares that he has no conflict of interest.
References
-
- Cohen MS, Gay C, Kashuba AD, Blower S, Paxton L. Narrative review: antiretroviral therapy to prevent the sexual transmission of HIV-1. Annals of Internal Medicine. 2007;146:591–601. - PubMed
-
- Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, et al. Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine. 2011;365:493–505. This randomized clinical trial provided definitive evidence that use of antiretroviral treatment by HIV-infected persons reduces the risk of HIV transmission to sexual partner. Use of antiretroviral medications for treatment of HIV infected persons to reduce infectiousness and PrEP for HIV uninfected persons to reduce susceptibility are complementary prevention strategies. - PMC - PubMed
-
- Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine. 2012;367:399–410. This randomized clinical trial demonstrated that oral PrEP, using daily oral FTC/TDF and daily oral TDF alone, was efficacious for prevention of HIV acquisition in both heterosexual men and women who were in HIV serodiscordant partnerships. - PMC - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous