Current Infectious Disease Reports

, Volume 14, Issue 2, pp 185–193

The Promise of Antiretrovirals for HIV Prevention

  • Charlene Flash
  • Douglas Krakower
  • Kenneth H. Mayer
Sexually Transmitted Diseases (L Bachmann, Section Editor)

Abstract

With an estimated 2.6 million new HIV infections diagnosed annually, the world needs new prevention strategies to partner with condom use, harm reduction approaches for injection drug users, and male circumcision. Antiretrovirals can reduce the risk of mother-to-child HIV transmission and limit HIV acquisition after occupational exposure. Macaque models and clinical trials demonstrate efficacy of oral or topical antiretrovirals used prior to HIV exposure to prevent HIV transmission, ie pre-exposure prophylaxis (PrEP). Early initiation of effective HIV treatment in serodiscordant couples results in a 96% decrease in HIV transmission. HIV testing to determine serostatus and identify undiagnosed persons is foundational to these approaches. The relative efficacy of different approaches, adherence, cost and long-term safety will affect uptake and impact of these strategies. Ongoing research will help characterize the role for oral and topical formulations and help quantify potential benefits in sub-populations at risk for HIV acquisition.

Keywords

HIV prevention Pre-exposure prophylaxis Microbicide Tenofovir Emtricitabine 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Charlene Flash
    • 1
  • Douglas Krakower
    • 1
  • Kenneth H. Mayer
    • 2
    • 1
  1. 1.Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  2. 2.The Fenway Institute, Fenway HealthBostonUSA

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