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. 2016 Nov 17;19(1):21263.
doi: 10.7448/IAS.19.1.21263. eCollection 2016.

Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model

Tim Horn  1 , Jennifer Sherwood  2 , Robert H Remien  3 , Denis Nash  4 , Judith D Auerbach  5 ; Treatment Action Group and Foundation for Aids Research HIV Prevention Continuum Working Group
Affiliations

Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model

Tim Horn et al. J Int AIDS Soc. .

Abstract

Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized.

Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well as those living with, HIV infection. We further discuss potential approaches to address gaps in data required for programme planning, implementation and evaluation across the elements of the HIV prevention continuum.

Conclusions: Our model conceptualizes opportunities to monitor and quantify primary HIV prevention efforts and, importantly, illustrates the interplay between an outcomes-oriented primary HIV prevention process and the HIV care continuum to move aggressively forward in reaching ambitious reductions in HIV incidence. To optimize the utility of this outcomes-oriented HIV prevention continuum, a key gap to be addressed includes the creation and increased coordination of data relevant to HIV prevention across sectors.

Keywords: HIV; PrEP; continuum; cycle; prevention; process model; testing.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Comprehensive HIV prevention processes. Conceptual framework illustrating the interplay between processes to halt both the acquisition and transmission of HIV. The primary HIV prevention cycle, left, begins with HIV testing. Risk and needs assessments, linkage to services, engagement in risk-reduction prevention interventions and HIV testing are repeated for as long as an individual remains at risk for HIV acquisition.
See this image and copyright information in PMC

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