Combination Prevention for HIV
1O’Neill Institute for National and Global Health Law, Georgetown University, 600 New Jersey Avenue North West, Washington DC, MD, USA and George W. Bush Institute, P.O. Box 600610, Dallas, TX 75360, USA
2London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
3World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland
Combination Prevention for HIV
Description
Recent scientific advances make it possible to consider ending the HIV epidemic, transforming it to a low-level endemic disease. To reach this ambitious goal, it will be necessary to combine these new advances with the more effective of the existing prevention efforts already in use. Combination prevention, though variously defined by different actors, is a growing effort to do just that. To understand the potential of combination prevention, it is important to recognize a few key “facts”: there are no “silver bullets,” no single intervention yet available that is powerful enough to end the HIV epidemic by itself; there is no “global HIV epidemic”- instead, there are only heterogeneous epidemics within regions and countries with different drivers and different sets or mixes of interventions required to control transmission. Combination prevention strategies that focus on providing the best mix of interventions (biomedical, behavioral, and structural interventions) in high transmission areas and to high-risk groups could allow countries to control the HIV epidemic. However, strategies alone will not yield the desired results. Significant policy, ethical, regulatory, and implementation issues also must be addressed.
The main focus of this special issue will be on combination prevention strategies for HIV, which includes an updated mix of new and existing prevention interventions, such as traditional behavioral and structural interventions and biomedical interventions (e.g., prevention of mother-to-child transmission, medical male circumcision (MMC), preexposure prophylaxis (PrEP), and treatment as prevention). The special issue will serve as an international forum for stakeholders (policymakers, researchers, health delivery professionals/providers, and advocates) to summarize the most recent developments and ideas in the field and examine the myriad issues associated with effective and sustainable delivery and implementation of combination prevention for HIV. Potential topics include, but are not limited to:
- Definition of combination prevention
- HIV prevention: historical perspective and review of the state of the science of HIV prevention
- Examination of interventions to be included, e.g., biomedical (PMTCT, MCC, PrEP, TasP), behavioral, and structural and evidence of effectiveness
- Epidemiological impact and cost modeling
- Country perspectives on delivery and implementation opportunities and challenges
- Normative perspectives and guidelines
- Regulatory challenges
- Civil society perspectives
- Legal and ethical issues
- Financing and sustainability
- Integration with broader health delivery platforms
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