Combination HIV prevention

Merson, Michael H.; Padian, Nancy; Coates, Thomas J.; Gupta, Geeta Rao; Bertozzi, Stefano; Piot, Peter; Mane, Pratibha; Bartoš, Michael

doi:10.1016/s0140-6736(08)61752-3

Cited by 67 publications

(39 citation statements)

References 2 publications

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“…The diminishing hope that a single behavioral or biomedical prevention intervention will be sufficient to address the growing HIV pandemic has heralded a programmatic shift towards combination HIV prevention programming [56][57][58][59]. By combining interventions with partial effectiveness targeted to populations most at risk, combination intervention packages should address both the biological and behavioral factors associated with transmission as well as the social and structural determinants that can aid or impede the success of HIV prevention programming [56][57][58][59]. Under this new paradigm, behavioral approaches to HIV prevention are critical components of prevention packages for both women and men, as a strategy to reduce high-risk sexual behavior and inform and educate the community, but also as a mechanism to improve the uptake, adherence, and proper use of biomedical intervention methods.…”

Section: Discussionmentioning

confidence: 99%

Behavior Change Interventions to Prevent HIV Infection among Women Living in Low and Middle Income Countries: A Systematic Review

2009

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We conducted a systematic review of behavioral change interventions to prevent the sexual transmission of HIV among women and girls living in low- and middle-income countries. PubMed/MEDLINE, Web of Science, the Cochrane Library, and other databases and bibliographies were systematically searched for trials using randomized or quasi-experimental designs to evaluate behavioral interventions with HIV infection as an outcome. We identified 11 analyses for inclusion reporting on eight unique interventions. Interventions varied widely in intensity, duration, and delivery as well as by target population. Only two analyses showed a significant protective effect on HIV incidence among women and only three of ten analyses that measured behavioral outcomes reduced any measure of HIV-related risk behavior. Ongoing research is needed to determine whether behavior change interventions can be incorporated as independent efficacious components in HIV prevention packages for women or simply as complements to biomedical prevention strategies.

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Section: Discussionmentioning

confidence: 99%

Behavior Change Interventions to Prevent HIV Infection among Women Living in Low and Middle Income Countries: A Systematic Review

2009

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“…Recent calls for "combination HIV prevention" and "back to basics" approaches to HIV emphasize the use of combinations of feasible and proven interventions. 10,11 A recent review listed priority STI control interventions to include "STI treatment of high-risk sub-populations, comprehensive case management of symptomatic STIs, antenatal syphilis screening and treatment and ophthalmia neonatorum prophylaxis, condom promotion and risk reduction counselling" with increased emphasis on the role of STI clinics in identifying and counselling HIV-infected persons and in diagnosing and managing their STIs. 12 The review pragmatically provides evidence for the effectiveness of individual intervention components within the fragmented domains of STI control and HIV prevention, while making a case for better alignment of efforts.…”

Section: Back To Basicsmentioning

confidence: 99%

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Steen¹,

Wi²,

Kamali³

et al. 2009

Bull World Health Org

114

103

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Control of sexually transmitted infections (STIs) is feasible, leads to improved sexual and reproductive health and contributes to preventing HIV transmission. The most advanced HIV epidemics have developed under conditions of poor STI control, particularly where ulcerative STIs were prevalent. Several countries that have successfully controlled STIs have documented stabilization or reversal of their HIV epidemics.STI control is a public health outcome measured by reduced incidence and prevalence. The means to achieve this include: (i) targeting and outreach to populations at greatest risk; (ii) promoting and providing condoms and other means of prevention; (iii) effective clinical interventions; (iv) an enabling environment; and (v) reliable data.Clinical services include STI case management, screening and management of STIs in sex partners. Syndromic case management is effective for most symptomatic curable STIs and screening strategies exist to detect some asymptomatic infections. Presumptive epidemiologic treatment of sex partners and sex workers complement efforts to interrupt transmission and reduce prevalence. Clinical services alone are insufficient for control since many people with STIs do not attend clinics. Outreach and peer education have been effectively used to reach such populations.STI control requires effective interventions with core populations whose rates of partner change are high enough to sustain transmission. Effective, appropriate targeting is thus necessary and often sufficient to reduce prevalence in the general population. Such efforts are most effective when combined with structural interventions to ensure an enabling environment for prevention. Reliable surveillance and related data are critical for designing and evaluating interventions and for assessing control efforts.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬ a

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“…Only five of these trials demonstrated a protective benefit, three focused on the same intervention (male circumcision), and four of them assessed prevention at the individual level and not the population level. As Padian and colleagues5 point out, part of the problem has been the focus on the discovery of a ‘magic bullet’ solution for HIV prevention, whereas there is increasing interest in shifting to combination prevention packages that could capitalise on synergies among interventions 6 7. This more comprehensive approach presumes that the causes of epidemics within specific contexts are known and that the correct intervention mix can therefore be selected.…”

mentioning

confidence: 99%

Emergent properties and structural patterns in sexually transmitted infection and HIV research

Blanchard

Aral

2010

Sexually Transmitted Infections

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Combination HIV prevention

Cited by 67 publications

References 2 publications

Behavior Change Interventions to Prevent HIV Infection among Women Living in Low and Middle Income Countries: A Systematic Review

Behavior Change Interventions to Prevent HIV Infection among Women Living in Low and Middle Income Countries: A Systematic Review

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Emergent properties and structural patterns in sexually transmitted infection and HIV research

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