Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

• Published in: The New England journal of medicine Vol. 367; no. 5; pp. 399 - 410
• Main Authors: Baeten, Jared M, Donnell, Deborah, Ndase, Patrick, Mugo, Nelly R, Campbell, James D, Wangisi, Jonathan, Tappero, Jordan W, Bukusi, Elizabeth A, Cohen, Craig R, Katabira, Elly, Ronald, Allan, Tumwesigye, Elioda, Were, Edwin, Fife, Kenneth H, Kiarie, James, Farquhar, Carey, John-Stewart, Grace, Kakia, Aloysious, Odoyo, Josephine, Mucunguzi, Akasiima, Nakku-Joloba, Edith, Twesigye, Rogers, Ngure, Kenneth, Apaka, Cosmas, Tamooh, Harrison, Gabona, Fridah, Mujugira, Andrew, Panteleeff, Dana, Thomas, Katherine K, Kidoguchi, Lara, Krows, Meighan, Revall, Jennifer, Morrison, Susan, Haugen, Harald, Emmanuel-Ogier, Mira, Ondrejcek, Lisa, Coombs, Robert W, Frenkel, Lisa, Hendrix, Craig, Bumpus, Namandjé N, Bangsberg, David, Haberer, Jessica E, Stevens, Wendy S, Lingappa, Jairam R, Celum, Connie
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 02-08-2012
• Subjects: Adenine - adverse effects; Adenine - analogs & derivatives; Adenine - therapeutic use; Adolescent; Adult; Anti-Retroviral Agents - adverse effects; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Biological and medical sciences; CD4 antigen; Contraception Behavior - statistics & numerical data; Counseling; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Double-Blind Method; Drug Combinations; Drug Resistance, Viral; Drug therapy; Emtricitabine; Female; General aspects; Heterosexuality; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Seropositivity; HIV-1 - genetics; HIV-1 - isolation & purification; Human immunodeficiency virus; Human viral diseases; Humans; Incidence; Infectious diseases; Male; Medical sciences; Middle Aged; Organophosphonates - adverse effects; Organophosphonates - therapeutic use; Pharmacology. Drug treatments; Pregnancy; Prophylaxis; RNA, Viral - blood; Sexual Behavior - statistics & numerical data; Tenofovir; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Human; Immunopathology; Antiretroviral agent; Heterosexuality; Sex; Male; AIDS; Immune deficiency; Infection; Medicine; Prevention; Viral disease; Antiviral; Female; Woman
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1108524

In this study of 4758 HIV-1–serodiscordant heterosexual couples in Kenya and Uganda, daily antiretroviral prophylaxis (with tenofovir or emtricitabine–tenofovir) in the HIV-1–negative partner significantly decreased the risk of HIV infection.
The use of antiretroviral medications for the prevention of HIV type 1 (HIV-1) transmission is a promising strategy for reducing the spread of HIV-1.
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Antiretroviral treatment for persons infected with HIV-1 provides important clinical benefits and substantially reduces infectiousness.
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Antiretroviral prophylaxis is a potential HIV-1–prevention strategy for those not yet infected with HIV-1, administered either as postexposure prophylaxis after high-risk occupational or nonoccupational exposure or as preexposure prophylaxis in those with ongoing HIV-1 exposure.
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The rationale for antiretroviral prophylaxis in persons with ongoing exposure is based on its efficacy in infants exposed to HIV-1 during birth and . . .