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Prevention of HIV Infection

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Current Trends and Concerns in Infectious Diseases

Part of the book series: Emerging Infectious Diseases of the 21st Century ((EIDC))

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Abstract

Remarkable progress has been made in the fight against HIV infection in the past 20 years. Since the advent of highly effective combination of antiretroviral agents [ART], there has been a dramatic decline in the mortality and morbidity from AIDS. However, over 2 million new cases of HIV infection were reported globally in 2014, but this is a downward trend as there were 3.5 million new cases in 2000. Early in the epidemic public health measures to reduce the spread of the infection depended on mass education of the public about safe sex with condoms, screening of blood products for the virus, advocating use of clean needles, needle exchange programs or avoidance of sharing needles among drug abusers, and testing of high-risk groups. These measures had some but limited benefit in halting the expansion of the HIV pandemic. Major success has been achieved, however, in preventing mother-to-child transmission with ART during pregnancy, at delivery and postpartum, with or without neonatal prophylaxis and almost zero perinatal transmission of HIV can be achieved. Early institution of ART at any stage of HIV infection has been shown to prevent new infections in discordant couples and in the at risk population, but primarily in high-income countries. Postexposure prophylaxis with ART after needle-stick injuries or high-risk sexual exposure is commonly used in developed countries and appears to be effective. More recently, clinical trials have shown variable success with preexposure prophylaxis with daily, long-term use of tenofovir/emtricitabine [Truvada] but efficacy is dependent on strict adherence. This chapter reviews the various preventative measures efficacy, drawbacks and cost-efficiency and reviews the progress in vaccine development.

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    I. W. Fong

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Fong, I.W. (2020). Prevention of HIV Infection. In: Current Trends and Concerns in Infectious Diseases. Emerging Infectious Diseases of the 21st Century. Springer, Cham. https://doi.org/10.1007/978-3-030-36966-8_1

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