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HIV Prevention: Treatment as Prevention (TasP), Occupational Postexposure Prophylaxis (oPEP), Nonoccupational Postexposure Prophylaxis (nPEP), and Pre-exposure Prophylaxis (PrEP)

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Abstract

In this chapter, we review selected literature reflecting on biomedical interventions that prevent HIV infection, and regarding treatment as prevention (TasP), also assist those living with HIV given its goal to effectively reduce infectivity by reducing people living with HIV’s viral load to an undetectable level. Unfortunately, in context to rural health care, little empirical data exists on these interventions, as standalone or combined approaches. What we know about TasP, occupational postexposure prophylaxis (oPEP), nonoccupational postexposure prophylaxis (nPEP), and pre-exposure prophylaxis (PrEP) is that they work, at least in clinical trials they worked. Theoretically, each poses significant potential to reduce HIV transmissions in all geographical settings. Realizing their potential in real-world settings, including rural areas, will require more resources that have yet to be allocated for large-scale implementation, especially concerning nPEP and PrEP. Ideally, our response system should consider developing integrated approaches that include all these interventions, in all jurisdictions. All the more critical, it will be essential to mobilize biomedical (e.g. medications and condoms), behavioral (e.g. cleaning needles prior to use or not sharing needles), and structural (e.g. eliminating stigma attached to HIV infection) interventions to achieve large-scale HIV prevention. In sum, since the discovery of HIV over three and a half decades ago, we have gained considerable knowledge that can and has improved our efforts to prevent (and treat) HIV. Now is the time to make this knowledge work to our advantage with a vision to end HIV transmissions.

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Notes

  1. 1.

    The 2015 HIV outbreak in Austin, Indiana (a town of ~4000) and pervasively high rates of prescription drug abuse suggests this trend may not hold (O’Malley, 2015).

  2. 2.

    Even with the decline in their rate over the prior decade, African American women remain disproportionately impacted compared to women of other racial backgrounds (60% of women’s HIV cases are African-American) (CDC, 2016a).

  3. 3.

    Texas, Oklahoma, Missouri, Louisiana, Mississippi, Alabama, Tennessee, Kentucky, Georgia, Florida, North and South Carolina, Virginia, Maryland, West Virginia and Delaware.

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Authors and Affiliations

  1. Georgia State University, Atlanta, USA

    Neal A. Carnes

  2. Georgia Department of Public Health, Atlanta, USA

    John Malone

  3. Emory University—Rollins School of Public Health, Atlanta, USA

    Jordan Helms

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  1. Neal A. Carnes
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  2. John Malone
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  3. Jordan Helms
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Correspondence to Jordan Helms .

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Editors and Affiliations

  1. Department of Leadership, Technology, and Human Development, Georgia Southern University, Statesboro, Georgia, USA

    Fayth M. Parks

  2. Division of Health Protection/IDI-HIV, Georgia Department of Public Health, Atlanta, Georgia, USA

    Gregory S. Felzien

  3. Organizational and Diversity Consultant, Los Angeles, California, USA

    Sally Jue

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Carnes, N.A., Malone, J., Helms, J. (2017). HIV Prevention: Treatment as Prevention (TasP), Occupational Postexposure Prophylaxis (oPEP), Nonoccupational Postexposure Prophylaxis (nPEP), and Pre-exposure Prophylaxis (PrEP). In: Parks, F., Felzien, G., Jue, S. (eds) HIV/AIDS in Rural Communities. Springer, Cham. https://doi.org/10.1007/978-3-319-56239-1_5

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  • DOI: https://doi.org/10.1007/978-3-319-56239-1_5

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