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    HIV Prevention Methods

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    John Henry
    HIV prevention strategies include traditional methods like abstinence and condoms as well as newer methods like PrEP and TasP. PEP involves taking ARVs within 72 hours of a potential exposure to reduce the risk of HIV transmission, while PrEP entails taking daily oral ARVs for those at substantial risk of acquiring HIV. TasP demonstrates that effectively suppressing a person's viral load through ART prevents onward transmission, known as U=U.

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    HIV Prevention Methods

    Uploaded by

    John Henry
    54 views7 pages
    HIV prevention strategies include traditional methods like abstinence and condoms as well as newer methods like PrEP and TasP. PEP involves taking ARVs within 72 hours of a potential exposure to reduce the risk of HIV transmission, while PrEP entails taking daily oral ARVs for those at substantial risk of acquiring HIV. TasP demonstrates that effectively suppressing a person's viral load through ART prevents onward transmission, known as U=U.

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    HIV prevention methods

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    HIV prevention strategies include traditional methods like abstinence and condoms as well as newer methods like PrEP and TasP. PEP involves taking ARVs within 72 hours of a potential exposure to reduce the risk of HIV transmission, while PrEP entails taking daily oral ARVs for those at substantial risk of acquiring HIV. TasP demonstrates that effectively suppressing a person's viral load through ART prevents onward transmission, known as U=U.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    54 views7 pages

    HIV Prevention Methods

    Uploaded by

    John Henry
    HIV prevention strategies include traditional methods like abstinence and condoms as well as newer methods like PrEP and TasP. PEP involves taking ARVs within 72 hours of a potential exposure to reduce the risk of HIV transmission, while PrEP entails taking daily oral ARVs for those at substantial risk of acquiring HIV. TasP demonstrates that effectively suppressing a person's viral load through ART prevents onward transmission, known as U=U.

    Copyright:

    © All Rights Reserved
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    of 7

    HIV Prevention Strategies

    • Traditional methods • Newer methods


    • Abstinence • Female condoms
    • Behavioural change • Male circumcision
    • Condoms (Male) • Pre-exposure
    • Safe blood supplies prophylaxis (PrEP)
    • Safe needle exchange • Vaginal ring (DPV-VR)
    • Treatment of STIs • TasP (U=U)
    • Post exposure
    prophylaxis (PEP)
    PEP HIV Post Exposure Prophylaxis
    Indications Parenteral or mucous membrane exposure (sexual exposure and
    splashes to the eye, nose or oral cavity)

    Body fluids that pose a risk for HIV ( blood, bloodstained saliva,
    breast milk, genital secretions, CSF, amniotic, rectal, peritoneal,
    synovial, pericardial or pleural fluids)

    When to start Should be initiated as early as possible, to all individuals with


    exposure that has the potential for HIV transmission, and ideally
    within 72 hours

    Regimen A regimen with 2 ARV drugs is effective, but 3 drugs are preferred
    (3TC/FTC + Raltegravir or Dolutegravir)

    Duration A 28-day prescription of ARV drugs

    Blood tests Initial then repeat HIV test 30d and 90d
    PrEP HIV Pre Exposure Prophylaxis
    Eligibility HIV negative; No suspicion of acute HIV infection
    Willingness to use PrEP as prescribed, periodic HIV testing
    PrEP is recommended for anyone with: (Substantial risk of HIV infection) eg
    • Condomless vaginal or anal sex with a partner of unknown HIV status
    • HIV-positive sex partner (especially if partner's HIV viral load is detectable or unknown)
    • A recent bacterial sexually transmitted infection (STI) (gonorrhoea/chlamydia/syphilis);
    Injection drug use with sharing of needles/equipment
    • Any survival/transactional sex
    • Desire to conceive with a partner who is HIV-positive

    Regimen Daily oral PrEP: TDF/FTC or TAF/FTC or TDF

    On-Demand or 2-1-1 Oral PrEP: Alternative for men who have sex with men (MSM) who
    have sex infrequently

    Injection PrEP: Cabotegravir (CAB) 600 mg IM (gluteal muscle) - initial dose, 2nd dose 1
    month after 1st dose, then every 2 months
    U=U (TasP)
    • Clinical studies have shown that using effective
    antiretroviral therapy (ART) to consistently suppress
    plasma HIV RNA levels to <200 copies/mL prevents
    transmission of HIV to sexual partners.

    • When ART is used to prevent HIV transmission, this


    strategy is called treatment as prevention (TasP),
    • commonly known as Undetectable = Untransmittable or U=U.

    • In the PARTNER, PARTNER 2 & OPPOSITES ATTRACT


    studies, NO within-couple HIV transmission occurred
    through condomless sex between serodiscordant
    heterosexuals or between male homosexual couples when
    the HIV-positive partners were on suppressive ART.
    WHO PMTCT
    Option B+
    Mother Triple ARVs regardless of CD4 count or WHO
    clinical stage, starting from diagnosis and
    continued for life
    Infant NVP or AZT (daily) from birth until age 4 to 6
    weeks (regardless of infant feeding method)

    The WHO recommends offering PrEP to pregnant and


    postpartum women at risk for HIV acquisition as an
    individual‐controlled prevention strategy

    CDC: Taking HIV medicine and maintaining an undetectable viral


    load during pregnancy, labor and delivery and while breastfeeding
    reduces the chances of transmission through breastfeeding to less
    than 1% .
    Summary
    • HIV is a RNA virus family retroviridae.
    • Replication: RNA→DNA → integration in host DNA
    • Its main receptors are CD4 and CXCR4 & CCR5
    • Diagnostic tests: EIA, RDT, NAAT, PCR etc.
    • Lab Diagnosis: requires at least 3 different tests
    • Ist Test: Highest sensitivity
    • 2nd & 3rd test: highest specificity
    • Limitations: FP & FN
    • Classes of ARV: EI, RTI, INSTI, PI, PE/B, CI, long
    acting injectables
    • Treatment: cART/HAART
    • Prevention: ABCs, PEP, PrEP, TasP (U=U), etc

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