Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2011 Jul;6(4):315-25.
doi: 10.1097/COH.0b013e32834788e7.

HIV-1 treatment as prevention: the good, the bad, and the challenges

Affiliations
Review

HIV-1 treatment as prevention: the good, the bad, and the challenges

Kumi Smith et al. Curr Opin HIV AIDS. 2011 Jul.

Abstract

Purpose of review: This work focuses on the use of antiretroviral agents to prevent the sexual transmission of HIV-1.

Recent findings: Two randomized clinical trials demonstrated that antiretroviral agents provided before exposure to HIV-1 offer substantial protection, ostensibly directly proportional to the concentration of antiretroviral therapy (ART) in the genital secretions. Intense focus on the use of HIV treatment as prevention has led to publication of modeling exercises, ecological studies, and observational studies, most of which support the potential benefits of ART. However, the logistical requirements for successful use of ART for prevention are considerable.

Summary: ART will serve as a cornerstone of combination prevention of HIV-1. Continued research will be essential to measure anticipated benefits and to detect implementation barriers and untoward consequences of such a program, especially increases in primary ART resistance.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Henry K, Chinnock BJ, Quinn RP, et al. Concurrent zidovudine levels in semen and serum determined by radioimmunoassay in patients with AIDS or AIDS-related complex. JAMA. 1988;259:3023–3026. - PubMed
    1. Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide,for the prevention of HIV infection in women. Science. 2010;329:1168–1174.This study is the first to report the results of a clinical trial demonstrating the effectiveness and safety of a 1% vaginal gel formulation of TDF for the prevention of HIV acquisition in women. Results show that the gel reduces HIV acquisition by an estimated 39% overall and by 54% in women with high gel adherence.

    1. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587–2599.This study is the first to report the results of a clinical trial demonstrating the efficacy of oral preprophylactic effect (iPREX) in preventing HIV among MSM in Asia and Africa. More information is needed to evaluate possible subclinical effects such as low-level drug resistance as well as potential adjustments in HIV risk behavior among users.

    1. Michael NL. Oral preexposure prophylaxis for HIV: another arrow in the quiver? N Engl J Med. 2010;363:2663–2665. - PubMed
    1. Nicol MR, Kashuba AD. Pharmacologic opportunities for HIV prevention. Clin Pharmacol Ther. 2010;88:598–609. - PMC - PubMed

MeSH terms

Substances