We neglect primary HIV prevention at our peril

Isbell, Michael T.; Kilonzo, Nduku; Mugurungi, Owen; Bekker, Linda‐Gail

doi:10.1016/s2352-3018(16)30058-3

Cited by 28 publications

(25 citation statements)

References 10 publications

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“…5 All of this underlines the need for novel approaches to strengthen implementation of HIV prevention programmes to increase the use of efficacious prevention methods. 6 Measuring coverage and impact of HIV prevention programmes has been proven to be challenging, partly due to scarcity of data and lack of standard indicators. 2 For treatment, the HIV treatment cascade, setting out the steps required for achieving viral suppression with antiretroviral therapy (ART), has provided a pragmatic and unifying framework for policy makers, programme planners, advocacy and civil society groups, and researchers, 7 driving the impressive global scale-up of HIV treatment services.…”

Section: Strengthening Hiv Prevention Through Cascadesmentioning

confidence: 99%

HIV prevention cascades: a unifying framework to replicate the successes of treatment cascades

et al. 2019

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Many countries are off track to meet targets for reducing new HIV infections. HIV prevention cascades have been proposed to assist in the implementation and monitoring of HIV prevention programmes by identifying gaps in the steps required for effective use of prevention methods, similar to HIV treatment cascades. However, lack of a unifying framework impedes widespread use of prevention cascades. Building on a series of consultations, we propose an HIV prevention cascade consisting of three key domains of motivation, access, and effective use in a priority population. This three-step cascade can be used for routine monitoring and advocacy, particularly by attaching 90-90-90-style targets. Further characterisation of reasons for gaps across motivation, access, or effective use allows for a comprehensive framework, guiding identification of relevant responses and platforms for interventions. Linking the prevention cascade, reasons for gaps, and interventions reconciles the different requirements of prevention cascades, providing a unifying framework.

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Section: Strengthening Hiv Prevention Through Cascadesmentioning

confidence: 99%

HIV prevention cascades: a unifying framework to replicate the successes of treatment cascades

et al. 2019

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“…Despite this progress, the optimism is tempered by concern that reducing HIV incidence rates must be further accelerated to guarantee epidemic control . Moreover, the recent gains have not been uniform.…”

Section: Global Contextmentioning

confidence: 99%

Building the evidence base to optimize the impact of key population programming across the HIV cascade

et al. 2018

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“…(1) This target will be missed by a considerable margin and the world is not on track to end the AIDS epidemic by 2030. (2)(3)(4) In fact, in 50 countries in the world, the number of new HIV infections increased, not decreased, since 2010, including countries in sub-Saharan Africa, where 70% of global people living with HIV (PLHIV) reside and more than 60% of global new HIV infections occur. (4) This "prevention crisis" is acknowledged in the 2018 UNAIDS Global AIDS Update (4).…”

Section: Introductionmentioning

confidence: 99%

Relationships between changes in HIV risk perception and condom use in east Zimbabwe 2003-2013: Population-based longitudinal analyses

Schaefer

Thomas

Maswera

et al. 2020

Preprint

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Background: Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception. Methods: Data on sexually active, HIV-negative adults (15-54 years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated. Results: 1988 males and 3715 females participated in ≥2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR]=1.39, 95% confidence interval [CI]=0.85-2.28, PAF=3.39%; females: aOR=1.41 [1.06-1.88], PAF=6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR=1.76 [1.12-2.78]; females: aOR=1.23 [0.93-1.62]) compared to those without change in risk perception. Conclusions: Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.

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We neglect primary HIV prevention at our peril

Cited by 28 publications

References 10 publications

HIV prevention cascades: a unifying framework to replicate the successes of treatment cascades

HIV prevention cascades: a unifying framework to replicate the successes of treatment cascades

Building the evidence base to optimize the impact of key population programming across the HIV cascade

Relationships between changes in HIV risk perception and condom use in east Zimbabwe 2003-2013: Population-based longitudinal analyses

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