Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/11365
Type
ArticleCopyright
Restricted access
Collections
- INI - Artigos de Periódicos [3378]
Metadata
Show full item record
HIV PREVENTION IN CLINICAL CARE SETTINGS 2014 RECOMMENDATIONS OF THE INTERNATIONAL ANTIVIRAL SOCIETY– USA PANEL
Antiretroviral Therapy, Highly Active
Statistical Analysis
HIV Infections/prevention & control
Terapia Antirretroviral de Alta Atividade
Análise Estatística
Infecções por HIV/prevenção & controle
Author
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
Kumarasamy, Nagalingeswaran
Shoptaw, Steven
Walensky, Rochelle P.
Dabis, Francois
Sugarman, Jeremy
Benson, Constance A.
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
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
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
HIVAntiretroviral Therapy, Highly Active
Statistical Analysis
HIV Infections/prevention & control
DeCS
HIVTerapia Antirretroviral de Alta Atividade
Análise Estatística
Infecções por HIV/prevenção & controle
Share