The preexposure prophylaxis revolution; from clinical trials to programmatic implementation.

摘要: PURPOSE OF REVIEW: An investment in preexposure prophylaxis (PrEP) delivery must have public health impact reducing HIV infections. Sustainable of PrEP requires policy integration services and synergy with other existing prevention programs. This review discusses key programmatic considerations for implementation scale up Africa. RECENT FINDINGS: has been delayed by concerns about adherence real world settings. Demonstration projects clinical service models are providing evidence effectiveness an much higher than that found randomized trials. Data confirm uptake retention high more so persons who perceive themselves at risk infection is well tolerated. dispensation a pill programs should address drivers which differ population. In Africa barriers to include stigma among MSM low perception young women. Additional data provided insight into optimal points provider training requirements quality assurance needs. Of the 2 million new infections 2014 70% were use not lifelong limited periods may be both effective cost-effective continent. SUMMARY: determine strategies identify those substantial formulate deliver combination interventions target social vulnerability specific each Policy guidance avenues protocols infrastructure required. Cost-effectiveness efficiency essential navigate ethical questions over antiretroviral therapy HIV-negative individuals when treatment coverage attained many parts Countries need invest purposeful advocacy local global forums. Failure implement will failure protect future generations.