HIV Prevention - A Comprehensive Approach

Front cover

HIV prevention: A comprehensive approach

Copyright page

Contents

Foreword

About the editors

Notes on contributors

Acknowledgments

Introduction

Part I: Epidemiological and biological issues in HIV prevention

Chapter 1 Current and future trends: implications for HIV prevention

Estimates and projections: methodology and refinements

Sub-pandemics in different world regions

Conceptual framework for HIV prevention

Multimodality of risk factors and impact on prevention interventions

Future trends

Conclusions

References

Chapter 2 Understanding the biology of HIV-1 transmission: the foundation for prevention

The assault force: HIV in genital secretions

Establishing a beachhead: the cellular organization of genital tract and rectal tissues, and early events in HIV sexual transmission

Summary and future directions

References

Chapter 3 HIV vaccines

Transmission and immunology of HIV and associated vaccine challenges

Challenges for HIV vaccine development

Vaccine approaches and evaluations

Vaccine candidates

Vaccine trials

The future of HIV vaccine efforts

Conclusions

Acknowledgment

References

Chapter 4 Microbicides

The biological rationale for microbicides

Microbicide development

The microbicide pipeline

Challenges to microbicide development

Socio-cultural perspectives on trial conduct in the developing world

Microbicides as part of the broader prevention agenda

Providing access to microbicides

Microbicide development remains a critical component of HIV prevention research

References

Chapter 5 Using antiretrovirals to prevent HIV transmission

HIV transmission

HIV in genital secretions

ART pharmacology

ART to Prevent Transmission of HIV

ART for post-exposure prophylaxis (PEP)

Clinical studies of non-occupational post-exposure prophylaxis

Pre-exposure prophylaxis to prevent HIV transmission

ART as public health prevention

ART and sexual behaviors: non-occupational post-exposure prophylaxis

ART resistance

Possible future strategies for ART as prevention: acute HIV infection

Conclusions

Acknowledgments

References

Chapter 6 Male circumcision and HIV prevention

Observational data on male circumcision and heterosexual HIV acquisition in men

Male circumcision and HIV acquisition in men who have sex with men

Randomized trials of male circumcision for HIV prevention in men

Biological evidence for the protective effects of circumcision for HIV prevention in men

Circumcision and STI acquisition in men

Male circumcision and HIV/STI infections in women

The safety of male circumcision

The prevalence and acceptability of male circumcision

Male circumcision and behavioral disinhibition or risk compensation

Modeling of the effects of male circumcision on population HIV incidence, the number of surgeries and cost per HIV infection averted

Scale-up of circumcision programs

References

Part II: Behavioral issues in HIV prevention

Chapter 7 Payoff from AIDS behavioral prevention research

Periods in AIDS prevention research

Conclusions

Acknowledgments

References

Chapter 8 Individual interventions

Stage 1: Common theoretical models applicable to individual interventions for HIV prevention

Stage 2: Selected efficacy trials of HIV prevention interventions based on the conceptual models

Stage 3: Summary and conclusions

Acknowledgment

References

Chapter 9 Couples' voluntary counseling and testing

Prevention through behavior change remains the best tool to control the epidemic

CVCT and correct and consistent condom use: what is known to work at the dyad level

Towards sustainable HIV prevention: structural and economic aspects, psychosocial elements, and social norms

Controversies: past and present

Best practices: a day in the life of a same-day CVCT clinic

Monitoring and evaluation of CVCT services

Twenty years of barriers and progress/concrete gains as CVCT evolves

Conclusion

References

Chapter 10 Updating HIV prevention with gay men: current challenges and opportunities to advance health among gay men

What is the evidence base for efficacy of HIV prevention efforts among gay men?

What are the current challenges in HIV prevention work among gay men?

Community viral load approaches to HIV prevention: reducing risk by changing context

How can we translate efficacy into effectiveness?

Towards a prevention cocktail: strategies to move HIV prevention among gay men forward

Steps toward the creation of a prevention cocktail

References

Chapter 11 Reducing sexual risk behavior among men and women with HIV infection

Sexual behavior among PLWHA

Intervention research addressing reduction in HIV transmission risk among PLWHA

Integration of HIV prevention programs into the clinical setting

Conclusions

References

Chapter 12 Injection drug use and HIV: past and future considerations for HIV prevention and interventions

Political and social context of injection drug use

Epidemiology of HIV infection among IDUs

Factors that have informed prevention and intervention strategies

Successful and unsuccessful interventions

Future directions

Acknowledgment

References

Chapter 13 HIV risk and prevention for non-injection substance users

Types of interventions used to treat substance use problems

Alcohol

Non-alcohol substance use

Use of other substances and HIV risk

Conclusions

References

Chapter 14 Preventing HIV among sex workers

Epidemiology, HIV risk and vulnerability among sex workers

Elements of effective interventions

The intervention gap and the need to scale up sex-worker interventions

Model programs from around the world

Challenges for setting up HIV prevention programs for sex workers

References

Chapter 15 Interventions with youth in high-prevalence areas

Epidemiology of HIV infection in youth

Young women and sexual risk

Reducing HIV risk

HIV prevention interventions in youth

Lessons learned from interventions targeted at youth

Conclusion

References

Chapter 16 Interventions with incarcerated persons

Epidemiology: the epidemic of incarceration in the United States

Prevention interventions

HIV/AIDS in international prisons

Future directions

Acknowledgments

References

Chapter 17 Preventing mother-to-child transmission of HIV

Progress in preventing mother-to-child transmission of HIV

Factors affecting mother-to-child transmission

Principles of prevention of MTCT: a comprehensive approach

Preventing mother-to-child transmission in high-resource settings: PMTCT advances

Preventing MTCT in low-resource settings: advances

Infant feeding: mother-to-child transmission through breastfeeding

From research to implementation

References

Part III: Structural and technical issues in HIV prevention

Chapter 18 Harm reduction, human rights and public health

Review of harm reduction interventions among vulnerable populations

The HIV epidemic among sex workers

The HIV epidemic among MSM

The HIV epidemic among incarcerated populations

Interplay between harm reduction, human rights and public health

Discussion

References

Chapter 19 HIV testing and counseling

History of HIV testing and counseling

HIV testing and counseling and behavior change

HIV testing and counseling models

Expanding HIV testing and counseling to reach specific populations

Continuing challenges and emerging issues

Advancing HIV testing and counseling

References

Chapter 20 Structural interventions in societal contexts

Venue-based approaches: wine shops to red-light districts

Social-network based approaches: prevention targeted at negotiating safe sex

Daughters, wives, and mothers: the impact of subordinating women in the home and community

Socially-driven public health responses

Targeting the individual in HIV prevention: condoms and antiretrovirals

Socially relevant HIV prevention

References

Chapter 21 Evaluating HIV/AIDS programs in the US and developing countries

Issues in defining the evaluation design

Types of summative evaluation

Major challenges in evaluating HIV/AIDS programs

Conclusion

References

Chapter 22 Adapting successful research studies in the public health arena: going from efficacy trials to effective public health interventions

Evaluating efficacy, effectiveness, and impact of biological interventions on HIV and STI incidence

Evaluating efficacy, effectiveness, and impact of behavioral interventions on HIV and STI risk behavior

Promoting the successful implementation of science-based HIV prevention: the CDC's approach

Emerging issues and challenges

Conclusions

Acknowledgment

Disclaimer

References

Index

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