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HIV Prevention in the United States:

Expanding the Impact

Expanding the Impact
Today’s
Epidemic
Proven
Prevention
Methods
Progress
To Date
Challenges
in HIV
Prevention
Future
of HIV
Prevention

We have more tools to effectively prevent HIV than ever before. Since no single strategy provides complete protection or is right for all individuals, a combination of methods is needed to help reduce HIV transmission. CDC and its partners are currently pursuing a High-Impact Prevention approach to reducing the continued toll of HIV. This approach seeks to use the best mix of proven, cost-effective, and scalable interventions for high-risk populations and areas of the nation (see “Future of HIV Prevention” fact sheet for information). Below is an overview of proven prevention strategies to date.


Proven Prevention Methods (print version)


Key References:

1Weinhardt LS, Carey MP, Johnson BT, et al. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997. Am J Public Health 1999;89(9):1397-1405.
2Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med 1994;331:1173-80.
3Perinatal HIV Guidelines Working Group. Public health service task force recommendations for use of antiretroviral drugs in pregnant HIV-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. April 29, 2009; pp 1-90. Available at: http://aidsinfo.nih.gov/ContentFiles/PerinatalGL.pdf. (Accessed June 25, 2012)
4Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. The HPTN 052 Study Team. N Engl J Med 2011. DOI:10.1056/nejmoa1105243.
5CDC. Case-control study of HIV seroconversion in health-care workers after percutaneous exposure to HIV-infected blood – France, United Kingdom, and United States, Jan 1988-Aug 1994. MMWR 1995;44:929-33.
6CDC. Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services. MMWR 2005;54(No. RR-2):1-20.
7Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. iPrEx Study Group. N Engl J Med 2010;363(27):2587-99.
8Thigpen MC, Kebaabetswe PM, Smith DK, et al. Daily oral antiretroviral use for the prevention of HIV infection in heterosexually active young adults in Botswana: results from the TDF2 study. 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention. July 17-20, 2011. Rome. Abstract WELBC01.
9Baeten J. Antiretroviral pre-exposure prophylaxis for HIV-1 prevention among heterosexual African men and women: the Partners PrEP study. 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention. July 17-20, 2011. Rome. Abstract MOAX0106.
10Choopanya K, Martin M, Suntharasamai P, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomized, double-blind, placebo-controlled phase 3 trial. Lancet 2013;381:2083-90.
11CDC. Condom Fact Sheet In Brief. Available at: http://www.cdc.gov/condomeffectiveness/brief.html. Published 2011. (Accessed June 25, 2012)
12Cohen DA , Farley TA, Bedimo-Etame JR, et al. Implementation of condom social marketing in Louisiana, 1993 to 1996. Am J Public Health 1999;89:204-8.
13CDC. Evolution of HIV/AIDS prevention programs – United States, 1981-2006. MMWR 2006; 55:597-603.
14Hogben M, McNally T, McPheeters M, et al. The effectiveness of HIV partner counseling and referral services in increasing identification of HIV-positive individuals: a systematic review. Am J Prev Med 2007; 33(2 Suppl):S89-100.
15CDC. Recommendations for partner services programs for HIV infections, syphilis, gonorrhea, and chlamydial infection. MMWR 2008;57(No. RR9):1-83.
16Fuller CM, Ford C, Rudolph A. Injection drug use and HIV: past and future considerations for HIV prevention and interventions. In: Mayer KH, Pizer HF, editors. HIV prevention: a comprehensive approach. London: Academic Press/Elsevier; 2009:305-39.
17Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999;75(1):3-17.
18Baeten JM, Strick LB, Lucchetti A, et al. Herpes simplex virus (HSV)-suppressive therapy decreases plasma and genital HIV-1 levels in HSV-2/HIV-1 coinfected women: a randomized, placebo- controlled, cross-over trial. J Infect Dis 2008 Dec 15;198(12):1804-8.
19Zuckerman RA, Lucchetti A, Whittington WL, et al. Herpes simplex virus (HSV) suppression with valacyclovir reduces rectal and blood plasma HIV-1 levels in HIV-1/HSV-2-seropositive men: a randomized, double-blind, placebo-controlled crossover trial. J Infect Dis 2007 Nov 15;196(10):1500-8.
20Dunne EF, Whitehead S, Sternberg M, et al. Suppressive acyclovir therapy reduces HIV cervicovaginal shedding in HIV-and HSV-2-infected women, Chiang Rai, Thailand. J Acquir Immune Defic Syndr 2008 Sep 1;49(1):77-83.
21Karim QA, Karim SS, Frohlich JA, et al; The CAPRISA 004 Trial Group. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science 2010 Sep 3: 329(5996):1168-74.
22Supachai Rerks-Ngarm, M.D., et al.; the MOPH–TAVEG Investigators. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med 2009;661(23):2209-20.

 
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