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prevention of HIV

Management: - strategy [1] - get patients HIV care to diminish risk of HIV transmission - antiretroviral treatment (ART) to prevent HIV transmission - improve adherence to antiretroviral treatment to diminish risk of HIV transmission - early antiretroviral therapy (ART) in patients with HIV reduces risks of their partners becoming infected [3] - no risk of HIV1 transmission in virally-suppressed patients with or without condom during heterosexual or homosexual intercourse [4] - reproductive care to diminish risk of sexual HIV transmission & perinatal HIV transmission - preexposure prophylaxis with vaginal ring containing dapivirine - 56% efficiency in women > 21 years of age [2] - 37% efficiency in women > 21 years, but only 15% in younger women [5]

Related

HIV1 infection; human immunodeficiency virus-1 infection infectivity of HIV safe sex (prevention of HIV1 & other STDs) screening for HIV1

Specific

post-exposure HIV prophylaxis pre-exposure HIV prophylaxis

General

prophylaxis (prevention, ppx)

References

  1. Centers for Disease Control & Prevention (CDC) Recommendations for HIV prevention with adults and adolescents with HIV in the United States, 2014 http://stacks.cdc.gov/view/cdc/26062
  2. Baeten JM, Palanee-Phillips T, Brown ER et al. Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. N Engl J Med 2016 Feb 22 PMID: 26900902 Free full text http://www.nejm.org/doi/10.1056/NEJMoa1506110
  3. Cohen MS, Chen YQ, McCauley M et al Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. July 18, 2016 PMID: 27424812 http://www.nejm.org/doi/full/10.1056/NEJMoa1600693
  4. Rodger AJ et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016 Jul 12; 316:171. PMID: 27404185 - Daar ES, Corado K. Condomless sex with virologically suppressed HIV-infected individuals: How safe is it? JAMA 2016 Jul 12; 316:149. PMID: 27404181
  5. Nel A, van Niekerk N, Kapiga S et al. Safety and efficacy of a dapivirine vaginal ring for HIV prevention in women. N Engl J Med 2016 Dec 1; 375:2133. PMID: 27959766 http://www.nejm.org/doi/10.1056/NEJMoa1602046 - Adimora AA. Preventing HIV among women - a step forward, but much farther to go. N Engl J Med 2016 Dec 1; 375:2195. PMID: 27959756 http://www.nejm.org/doi/10.1056/NEJMe1613661