Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

19 April 2012

The Effectiveness of ARV's Used for HIV Prevention

via AIDSmeds, by Tim Horn

While studies exploring the effectiveness of antiretroviral (ARV) therapy for HIV prevention purposes have generally yielded encouraging results, a group of researchers at the University of North Carolina at Chapel Hill suggest that the way forward is not entirely clear and that additional research is needed, particularly in understanding the combined benefits of biomedical and behavioral interventions in specific at-risk communities.  

“Recent research developments in [pre-exposure prophylaxis, or PrEP] and [treatment of people living with HIV to curtail HIV transmission] provide a unique opportunity to highlight areas of advancement that have galvanized changes in HIV treatment and prevention, and to highlight topic areas that remain undecided and controversial,” write Myron Cohen, MD, and his colleagues in an editorial published ahead of print by the journal AIDS.

The paper reviews much of the scientific research that has contributed to our current understanding of ARV treatment as prevention, including pharmacologic and observational studies, ecological evaluations and various modeling and empirical data. And despite the completion of several sound clinical trials—also summarized by Cohen and his colleagues and reviewed here—gaps in knowledge remain.

The Limits of HPTN 052

Building on the results of cohort and mathematical modeling studies, the HIV Prevention Trials Network began a randomized clinical trial, called study 052 (HPTN 052), to confirm a prevention effect from ARV therapy. While the study is ongoing, its Data Safety and Monitoring Board recommended nearly a year ago that the interim results be made publicly available.

As previously reviewed by AIDSmeds, the trial demonstrated a 96 percent reduction in HIV transmission among monogomous heterosexual HIV-serodiscordant couples in which the HIV-positive partner was started on ARV therapy, compared with couples in which the positive partner had not started HIV treatment.

Read the rest.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

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