Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/11365
Title: HIV prevention in clinical care settings 2014 recommendations of the international antiviral society– USA panel
Authors: Marrazzo, Jeanne M.
Del Rio, Carlos
Holtgrave, David R.
Cohen, Myron S.
Kalichman, Seth C.
Mayer, Kenneth H.
Montaner, Julio S. G.
Wheeler, Darrell P.
Grant, Robert M.
Grinsztejn, Beatriz Gilda Jegerhorn
Kumarasamy, Nagalingeswaran
Shoptaw, Steven
Walensky, Rochelle P.
Dabis, Francois
Sugarman, Jeremy
Benson, Constance A.
Affilliation: University of Washington. Seattle, WA, United States of America
Emory University. Atlanta, GA, United States of America
The Johns Hopkins Bloomberg School of Public Health. Baltimore, MD, United States of America
University of North Carolina at Chapel Hill. Chapel Hill, NC, United States of America
University of Connecticut. Storrs, CT, United States of America
Harvard Medical School. Boston, MA, United States of America
University of British Columbia. Vancouver, BC, Canada
Loyola University Chicago. Chicago, IL, United States of America
University of California San Francisco. San Francisco, CA, United States of America
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil
YR Gaitonde Centre for AIDS Research and Education. Chennai, India
University of California Los Angeles. Los Angeles, CA, United States of America
Massachusetts General Hospital. Boston, MA, United States of America
Université de Bordeaux. Bordeaux, France
The Johns Hopkins University. Baltimore, MD, United States of America
University of California San Diego. San Diego, CA, United States of America
Abstract: IMPORTANCE Emerging data warrant the integration of biomedical and behavioral recommendations for human immunodeficiency virus (HIV) prevention in clinical care settings. OBJECTIVE To provide current recommendations for the prevention of HIV infection in adults and adolescents for integration in clinical care settings. DATA SOURCES, STUDY SELECTION, AND DATA SYNTHESIS Data published or presented as abstracts at scientific conferences (past 17 years) were systematically searched and reviewed by the International Antiviral (formerly AIDS) Society—USA HIV Prevention Recommendations Panel. Panel members supplied additional relevant publications, reviewed available data, and formed recommendations by full-panel consensus. RESULTS Testing for HIV is recommended at least once for all adults and adolescents, with repeated testing for those at increased risk of acquiring HIV. Clinicians should be alert to the possibility of acute HIV infection and promptly pursue diagnostic testing if suspected. At diagnosis of HIV, all individuals should be linked to care for timely initiation of antiretroviral therapy (ART). Support for adherence and retention in care, individualized risk assessment and counseling, assistance with partner notification, and periodic screening for common sexually transmitted infections (STIs) is recommended for HIV-infected individuals as part of care. In HIV-uninfected patients, those persons at high risk of HIV infection should be prioritized for delivery of interventions such as preexposure prophylaxis and individualized counseling on risk reduction. Daily emtricitabine/tenofovir disoproxil fumarate is recommended as preexposure prophylaxis for persons at high risk for HIV based on background incidence or recent diagnosis of incident STIs, use of injection drugs or shared needles, or recent use of nonoccupational postexposure prophylaxis; ongoing use of preexposure prophylaxis should be guided by regular risk assessment. For persons who inject drugs, harm reduction services should be provided (needle and syringe exchange programs, supervised injection, and available medically assisted therapies, including opioid agonists and antagonists); low-threshold detoxification and drug cessation programs should be made available. Postexposure prophylaxis is recommended for all persons who have sustained a mucosal or parenteral exposure to HIV from a known infected source and should be initiated as soon as possible. CONCLUSIONS AND RELEVANCE Data support the integration of biomedical and behavioral approaches for prevention of HIV infection in clinical care settings. A concerted effort to implement combination strategies for HIV prevention is needed to realize the goal of an AIDS-free generation.
Keywords: HIV
Antiretroviral Therapy, Highly Active
Statistical Analysis
HIV Infections/prevention & control
DeCS: HIV
Terapia Antirretroviral de Alta Atividade
Análise Estatística
Infecções por HIV/prevenção & controle
Issue Date: 2014
Publisher: American Medical Association
Citation: MARRAZZO, Jeanne M. et al. HIV prevention in clinical care settings 2014 recommendations of the international antiviral society– USA panel. Journal of the American Medical Association, v.312, n.4, p.390-409, 2014.
DOI: 10.1001/jama.2014.7999
ISSN: 0098-7484
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos

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