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Translating Pre-Exposure Prophylaxis Evidence into Practice and Public Health Impact

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Biomedical Advances in HIV Prevention

Abstract

Since July 2010, there have been five clinical trials demonstrating the efficacy of antiretrovirals as treatment or oral/topical prophylaxis, in preventing HIV. One of the biggest challenges facing HIV prevention is how to translate these biomedical HIV prevention technologies with high adherence to achieve public health impact to turn the tide of the epidemic. The rapidly evolving field of HIV prevention is about to embark on the challenge of translating efficacy observed in clinical trial conditions into effectiveness in the real world. This task, looming large, presents a particular challenge because it requires multiple biomedical, behavioral, and social interventions in combination to maximize their synergy as appropriate for each unique epidemic setting. In real-world settings, particular efforts will be needed to ensure high adherence, as two trials of pre-exposure prophylaxis did not show efficacy principally due to poor adherence to daily regimens. Despite the numerous challenges in implementing antiretroviral treatment for prevention, it has, in conjunction with pre-exposure prophylaxis, created newfound optimism in HIV prevention. Most importantly, antiretroviral implementation is gaining momentum despite obstacles and its impact on the HIV epidemic is becoming evident.

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Author information

Authors and Affiliations

  1. CAPRISA—Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, 4013, Durban, KwaZulu-Natal, South Africa

    Salim S. Abdool Karim & Cheryl Baxter

  2. Columbia University, New York, USA

    Salim S. Abdool Karim

  3. South African Medical Research Council, Tygerberg, South Africa

    Salim S. Abdool Karim

Authors
  1. Salim S. Abdool Karim
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  2. Cheryl Baxter
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Correspondence to Salim S. Abdool Karim .

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Editors and Affiliations

  1. Dept. of Human Develop. & Family Studies, University of Connecticut, Storrs, Connecticut, USA

    Lisa A. Eaton

  2. Ctr for Health Intervention & Prevention, University of Connecticut, Storrs, Connecticut, USA

    Seth C. Kalichman

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Abdool Karim, S., Baxter, C. (2014). Translating Pre-Exposure Prophylaxis Evidence into Practice and Public Health Impact. In: Eaton, L., Kalichman, S. (eds) Biomedical Advances in HIV Prevention. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8845-3_2

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  • DOI: https://doi.org/10.1007/978-1-4614-8845-3_2

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