The key role of adherence for the effectiveness of antiretroviral-based prevention: state of the science and implications for the Asia-Pacific region

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 155 ◽  
Author(s):  
K. Rivet Amico
Keyword(s):  
At Risk ◽  
Hiv Treatment ◽  
Asia Pacific ◽  
Treatment As Prevention ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Effective Prevention ◽  
Widespread Access ◽  
Hiv Treatment As Prevention ◽  
Exposure Prophylaxis

Remarkable advances have been made in the last few years in biomedical strategies to prevent onward transmission of HIV (treatment as prevention (TasP)) and prevent infection among at-risk populations through pre-exposure prophylaxis (PrEP). Numerous issues remain heavily debated, primarily concerning the feasibility of leveraging resources for both widespread access to antiretroviral therapy (ART) for those living with HIV and access to effective prevention antiretrovirals (ARVs) among those at risk for infection. Even with consistent and wide-spread access to ARVs, the behavioural pathway from ARV access to successful rapid and durable suppression or reaching levels of PrEP adherence that confer high rates of protection is increasingly well recognised. For either ‘biobehavioural’ strategy to have maximal individual and community benefit, individuals accessing them must actually use them. In this review, the unique and overlapping factors influencing adherence to ART and PrEP are identified, with an emphasis on the behavioural, social and structural facilitators and barriers to TasP and PrEP success. The implications of the current research base and evidence generated specifically within the Asia-Pacific region are discussed.

HIV pre-exposure prophylaxis and treatment as prevention: a review of awareness and acceptability among men who have sex with men in the Asia-Pacific region and the Americas

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 166 ◽  
Author(s):  
Martin Holt
Keyword(s):  
The United States ◽  
Hiv Treatment ◽  
Asia Pacific ◽  
Treatment As Prevention ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Acceptability Research ◽  
Prevention Trials ◽  
Sex With Men ◽  
Exposure Prophylaxis

This review assesses acceptability research for HIV pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) among men who have sex with men (MSM) in the Asia-Pacific region and the Americas, evaluating awareness and attitudes. There has been limited research on the acceptability of PrEP outside the United States and no research to date evaluating the acceptability of TasP since the findings of the HIV Prevention Trials Network 052 trial were released. Existing research suggests that PrEP is reasonably acceptable to MSM, but few men are likely to perceive the need for it. Studies of HIV treatment optimism suggest that MSM are likely to be sceptical of TasP.

A rapid review of pre-exposure prophylaxis for HIV in the Asia–Pacific region: recommendations for scale up and future directions

Sexual Health ◽  
2021 ◽  
Vol 18 (1) ◽  
pp. 31 ◽  
Author(s):  
Partha Haldar ◽  
Sushena Reza-Paul ◽  
Roy Arokiam Daniel ◽  
Lisa Lazarus ◽  
Bharat Bhushan Rewari ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hiv Prevention ◽  
World Health ◽  
Asia Pacific ◽  
Rapid Review ◽  
Pacific Region ◽  
Prevention Strategies ◽  
Asia Pacific Region ◽  
Effective Prevention ◽  
Exposure Prophylaxis

Decline in new HIV infections in the Asia–Pacific region (APAC) continues to be slow, emphasising the importance of scaling up new HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). To help inform PrEP rollout in APAC, we conducted a rapid review of published literature on PubMed from 2015 to 2020, to assess feasibility, implementation strategies, cost-effectiveness, and availability of national policies and guidelines; for the latter, we also did an expanded Internet search. This review focussed on nine countries contributing >95% of new infections in this region. A total of 36 PrEP-related studies conducted among men who have sex with men, female sex workers, and transgender women were included, of which 29 were quantitative, six were qualitative and one was a mixed-method study. Most of the studies have addressed the availability and acceptability of PrEP, whereas cost-effectiveness of any approach was assessed by limited studies. Limited published information was available about national PrEP policies and guidelines; of the selected nine countries, five have adopted the recommended World Health Organization PrEP policy of which four have integrated it in their national HIV response. HIV risk perception concerns about safety, side-effects, stigma, and affordability were major challenges to PrEP acceptance. Community-based implementation has the potential to address these. Limited evidence suggested merging PrEP implementation with ongoing targeted intervention and treatment programs could be a cost-effective approach. To stem the epidemic, newer effective prevention strategies, like PrEP, should be urgently adopted within the context of combination HIV prevention approaches.

scholarly journals Depression, Anxiety, and Stress During the COVID-19 Pandemic: Comparison Among Higher Education Students in Four Countries in the Asia-Pacific Region

2021 ◽  
Vol 29 ◽  
pp. 370-383
Author(s):  
Na Jiang ◽  
◽  
Siaw Yan-Li ◽  
Kanit Pamanee ◽  
Joko Sriyanto ◽  
...  
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
At Risk ◽  
Quantitative Research ◽  
Mental Health Problems ◽  
Scientific Information ◽  
Psychological Problems ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region

The global COVID-19 pandemic is affecting the health of individuals and leading to psychological problems. Students in higher education who are graduating, facing online learning challenges, and future job opportunities are among the most at-risk group for psychological issues. Due to the new normal of the COVID-19 pandemic, limited studies have been conducted concerning the mental health of students, especially in the Asia-Pacific region. Therefore, this study aimed to assess student’s depression, anxiety, and stress status in four countries in the Asia Pacific region, namely, Malaysia, Indonesia, Thailand, and China. This study employed a quantitative research design with a pool of 1,195 student participants. The DASS-21 questionnaire was used for data collection through an online platform to measure the severity of depression, anxiety, and stress. Descriptive statistics were conducted to achieve the research objectives, and all reliability values were reported greater than 0.70. Findings revealed that up to 38% of the students reported mild or moderate depression, anxiety, and stress, while 20.5% reported severe or extremely severe anxiety. Overall, anxiety was reported to be the most significant problem among the students, followed by depression and stress. Students are at risk of mental health challenges during the coronavirus pandemic, likely due to unexpected life changes. This study contributes an overview report of students’ mental health problems and discusses the support and services in preventing students’ psychological problems. The comprehensive discussion has provided scientific information and suggestion to policymakers in maintaining the student academic and welfare.

scholarly journals APSIC guidelines for the prevention of surgical site infections

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Moi Lin Ling ◽  
Anucha Apisarnthanarak ◽  
Azlina Abbas ◽  
Keita Morikane ◽  
Kil Yeon Lee ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Surgical Site Infections ◽  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Effective Prevention ◽  
Healthcare Facilities ◽  
Quality Improvement Process ◽  
Improvement Process ◽  
Guidelines And Recommendations

Abstract Background The Asia Pacific Society of Infection Control (APSIC) launched the APSIC Guidelines for the Prevention of Surgical Site Infections in 2018. This document describes the guidelines and recommendations for the setting prevention of surgical site infections (SSIs). It aims to highlight practical recommendations in a concise format designed to assist healthcare facilities at Asia Pacific region in achieving high standards in preoperative, perioperative and postoperative practices. Method The guidelines were developed by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section. Results It recommends that healthcare facilities review specific risk factors and develop effective prevention strategies, which would be cost effective at local levels. Gaps identified are best closed using a quality improvement process. Surveillance of SSIs is recommended using accepted international methodology. The timely feedback of the data analysed would help in the monitoring of effective implementation of interventions. Conclusions Healthcare facilities should aim for excellence in safe surgery practices. The implementation of evidence-based practices using a quality improvement process helps towards achieving effective and sustainable results.

Sex partners as bystanders in HIV prevention trials: Two test cases for research ethics

2019 ◽  
Vol 16 (5) ◽  
pp. 455-457
Author(s):  
Till Bärnighausen
Keyword(s):  
Hiv Prevention ◽  
Research Ethics ◽  
Hiv Treatment ◽  
Treatment As Prevention ◽  
Test Cases ◽  
Sex Partners ◽  
Research Subjects ◽  
Prevention Trials ◽  
Hiv Treatment As Prevention ◽  
Exposure Prophylaxis

Research involving human subjects can impose risk on some ‘bystanders’– people who are not themselves research subjects but whom the study may affect. We examine the consequences of research for a particular category of bystanders – research subjects’ sex partners – in trials testing interventions to reduce (1) HIV transmission (HIV treatment-as-prevention trials) and (2) HIV acquisition (HIV pre-exposure prophylaxis trials). Both types of trials provide useful test cases for assessing whether bystanders to research deserve special consideration in ethics reviews, and potentially some of the benefits and protections that research subjects receive. In HIV treatment-as-prevention trials, there are two groups of people who are alike in many important respects but treated very differently by research ethics: research subjects who contribute data on the primary endpoint of the trial (because some of them have sex with the people receiving the treatment conditions of the trials) – and bystanders who are not enrolled in the trials but who could have contributed primary endpoint data in the same way as the first group. In pre-exposure trials, the sex partners of people participating in pre-exposure prophylaxis trials are bystanders, even though they are necessary for the success of the trial. Research subjects’ autonomy is fiercely protected by trial enrolment processes. Bystanders, by contrast, often have no choice but to be affected by the study, because of their relationship to a research subject. In HIV prevention trials, standing by can come with important risks, including the same ones on which the success of the research hinges. It is thus important to consider the ethical obligations to protect bystanders, and the related procedural responsibilities.

Review of Counseling in the Asia-Pacific Region.

1995 ◽  
Vol 40 (4) ◽  
pp. 383-384
Author(s):  
Terri Gullickson
Keyword(s):  
Asia Pacific ◽  
Pacific Region ◽  
Asia Pacific Region
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