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1. HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures

HIV in pregnancy: Identification of intrapartum and perinatal HIV exposures The benefits of human immunodeficiency virus (HIV) testing in pregnancy, when combined with appropriate maternal antiretroviral therapy and intrapartum and postnatal prophylaxis, are well established. The vertical rate of transmission of HIV in North America is now well below 2%. Efforts must continue to ensure that these benefits are sustained. Women who have received little or no prenatal care and those who present (...) for delivery with unknown HIV status need immediate testing. As more infants are exposed to antiretroviral agents, strategies need to be implemented to ensure adequate follow-up of these infants. Issues relating to the identification of HIV-exposed infants are highlighted. Keywords: Human immunodeficiency virus; Infant; Intrapartum transmission; Pregnancy; Screening

2019 Canadian Paediatric Society

2. The efficacy of post-exposure prophylaxis (PEP) for HIV

The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network The efficacy of post-exposure prophylaxis (PEP) for HIV The efficacy of post-exposure prophylaxis (PEP) for HIV , , , Questions What is the efficacy of PEP when used for non-occupational exposure? What is the efficacy of PEP when used for occupational exposure? Are specific PEP regimens more efficacious than others (...) ? What are key factors implicated in the efficacy or inefficacy of PEP? Key take-home messages PEP initiated soon after exposure can reduce the risk of HIV seroconversion after occupational and non-occupational exposures, provided adherence to medications is sufficient (1–4). Evidence suggests that individuals prescribed tenofovir-based two- or three-drug regimens are more likely to complete a course of PEP and have lower discontinuation rates due to adverse events compared to zidovudine-based

2019 Ontario HIV Treatment Network

3. Economic evaluations of pre- and post-exposure prophylaxis for HIV

Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Economic evaluations of pre- and post-exposure prophylaxis for HIV Economic evaluations of pre- and post-exposure prophylaxis for HIV , , Questions What is the cost-effectiveness of HIV post-exposure prophylaxis? What is the cost-effectiveness of HIV pre-exposure prophylaxis? What are the gaps (...) in literature? Key take-home messages Economic evaluations of health care interventions can inform resource allocation and policy development. However, interpreting and generalizing results can be challenging (1). PrEP can be cost-effective or cost-saving depending on the local context, adherence rates, and program coverage (1). Interventions that target individuals at high risk of HIV exposure may improve the cost-effectiveness of PrEP (1–3). Non-occupational PEP may be cost-effective, or even cost-saving

2019 Ontario HIV Treatment Network

4. Post-exposure HIV prophylaxis

Post-exposure HIV prophylaxis Post-exposure HIV prophylaxis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Post-exposure HIV prophylaxis Last reviewed: February 2019 Last updated: May 2018 Summary Post-exposure prophylaxis (PEP) must be initiated as soon as possible, ideally within 2 hours, and preferably within 24 hours of exposure. However, the period during which PEP is most efficacious is often said to be within (...) 72 hours of exposure. Most exposures have only a low risk of HIV transmission even in the absence of PEP. PEP given to HIV-negative people reduces likelihood of HIV seroconversion by approximately 80%. Duration of treatment is 28 days. New antiretroviral treatment regimens for PEP offer low risk of toxicity. There is an absence of randomised controlled studies evaluating PEP. Definition Post-exposure prophylaxis (PEP) is the administration of antiretroviral therapy (ART) to HIV-negative people

2018 BMJ Best Practice

5. Risky sexual behaviour to HIV exposure and infection among HIV serum negative and unknown HIV status men who have sex with men in uptake of pre-exposure prophylaxis antiretroviral therapy (PrEP) and post-exposure prophylaxis antiretroviral therapy (PEP):

Risky sexual behaviour to HIV exposure and infection among HIV serum negative and unknown HIV status men who have sex with men in uptake of pre-exposure prophylaxis antiretroviral therapy (PrEP) and post-exposure prophylaxis antiretroviral therapy (PEP): Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content

2018 PROSPERO

6. A randomised controlled trial of a telephone administered brief HIV risk reduction intervention amongst men who have sex with men prescribed post-exposure prophylaxis for HIV after sexual exposure in the UK: Project PEPSE. (PubMed)

A randomised controlled trial of a telephone administered brief HIV risk reduction intervention amongst men who have sex with men prescribed post-exposure prophylaxis for HIV after sexual exposure in the UK: Project PEPSE. In western countries, men who have sex with men (MSM) are most affected by HIV and increasingly likely to engage in risky sexual behaviour. MSM who experience a potential sexual exposure to HIV (PEPSE) and receive a preventative regimen of anti-HIV treatment (...) are at particularly high risk of acquiring HIV and could potentially benefit from targeted risk reduction behavioural interventions such as motivational interviewing (MI).The aim of this trial was to examine the impact of augmented MI (MI plus information provision and behavioural skills building), over and above routine care, on reducing risky sexual behaviour in MSM prescribed PEPSE. Secondary aims of the research were to examine whether the intervention reduced sexually transmitted infections (STI) and further

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2019 PLoS ONE Controlled trial quality: uncertain

7. Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV

Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV Effectiveness of oral pre-exposure prophylaxis (PrEP) for HIV , , , , , , , Questions What is the efficacy of oral tenofovir disoproxil fumarate with or without emtricitabine as pre-exposure prophylaxis (PrEP) for HIV in the context (...) emerging biomedical prevention interventions with current prevention strategies offers the best hope of reducing new HIV infections (17). One of these biomedical prevention strategies is pre-exposure prophylaxis (PrEP), which relies on self-administration of antiretroviral medication before anticipated exposure to HIV (17). At the time of writing, the only regimens of PrEP approved by national and international guidelines are an oral dosage containing a formulation of tenofovir disoproxil fumarate

2018 Ontario HIV Treatment Network

8. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV UPDATED RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018 INTERIM GUIDELINES HIV TREATMENTUPDATED (...) RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV: INTERIM GUIDELINES SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018WHO/CDS/HIV/18.51 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https

2019 World Health Organisation HIV Guidelines

9. Tenofovir with emtricitabine for HIV pre-exposure prophylaxis (PrEP)

Tenofovir with emtricitabine for HIV pre-exposure prophylaxis (PrEP) Tenofovir with emtricitabine for HIV pre-exposure prophylaxis (PrEP) - NPS MedicineWise Log In Menu Featured topics Professional development NPS Publications An independent peer-reviewed journal providing critical commentary on drugs and therapeutics. Timely, independent, evidence-based information on new drugs and medical tests, and changes to the PBS and MBS. Featured topics Talk to a professional Information for consumers (...) -based information for Australian health professionals and consumers. Featured resources 2 October 2019 2 October 2019 26 September 2019 Featured topic 20 years of helping Australians make better decisions about medicines, medical tests and other health technologies Partner with us Latest projects Search Search Search Search POPULAR Log in Log in All fields are required Email address* Password* Log in Tenofovir with emtricitabine for HIV pre-exposure prophylaxis (PrEP) The first pharmacological

2018 National Prescribing Service Limited (Australia)

10. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis

Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis E1448 CMAJ | NOVEMBER 27, 2017 | VOLUME 189 | ISSUE 47 © 2017 Joule Inc. or its licensors N ew HIV infections occur every year in Canada, 1 highlighting the need for integrated prevention programs. Pre-exposure pro- phylaxis (PrEP) and nonoccupational postexposure prophy- laxis (nPEP) are two important strategies for preventing HIV that should be considered standard of care and implemented (...) as components of a comprehensive response to the epidemic. Pre-exposure prophylaxis is the use of certain antiretroviral medications by HIV-uninfected per- sons who are at high, ongoing risk of HIV acquisition, beginning before and continuing after potential HIV exposures. Postexposure prophy- laxis (PEP) involves 28 days of antiretroviral medications immediately after a specific HIV exposure, and is “nonoccupational” (nPEP) when used after sexual and injection drug use exposures, rather than acci- dental

2017 CPG Infobase

11. Recommendation for HIV post-exposure prophylaxis (PEP) following occupational exposure to a source with undetectable HIV viral load

Recommendation for HIV post-exposure prophylaxis (PEP) following occupational exposure to a source with undetectable HIV viral load EAGA Secretariat December 2013 Expert Advisory Group on AIDS Providing expert scientific advice on HIV Updated recommendation for HIV post-exposure prophylaxis (PEP) following occupational exposure to a source with undetectable HIV viral load At its meeting on 23 October 2013 (EAGA95), the Expert Advisory Group on AIDS (EAGA) reviewed the evidence around the risk (...) of occupational HIV transmission from a source/patient with no detectable HIV RNA in their plasma. EAGA had previously advised that HIV PEP was not recommended under these circumstances. However, guidelines published by the US Public Health Service in September 2013 recommended PEP should still be offered. Full details of the discussion at EAGA are available in the published minutes (link). The advice from EAGA is summarised below. Situation: Occupational exposure of a healthcare worker, by percutaneous

2013 Publication 4880703

12. BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP)

BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP) Guideline writing group Michael Brady (Co-chair) Consultant in Sexual Health and HIV, King’s College Hospital, London Alison Rodger (Co-chair) Reader and Honorary Consultant Infectious Diseases and HIV, University College London David Asboe Consultant HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London Valentina Cambiano Lecturer in Infectious Disease Modelling and Biostatistics, University (...) on the use of HIV pre-exposure prophylaxis (PrEP) 2018 BHIVA/BASHH guidelines on the use of PrEP 2 Contents 1 Objectives 6 1.1 Inclusivity 6 2 Methods 7 2.1 Search strategy 7 2.2 GRADE system 7 2.2.1 Good practice points 8 2.3 Stakeholder involvement, piloting and feedback 8 2.4 Generic preparations of tenofovir disoproxil 8 2.5 References 8 3 Summary of recommendations 9 4 Evidence for safety and efficacy in key populations 15 4.1 Evidence for safety and efficacy in men who have sex with men (MSM) 15

2018 British Association for Sexual Health and HIV

13. HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies

HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies | CADTH.ca CADTH Document Viewer HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies Table of Contents Search this document HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil (...) of high-risk sexual encounters — precautions that may not be accepted by some individuals. This situation changed in 2012 with the FDA approval and availability of the fixed-dose antiviral combination emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) Truvada, manufactured by Gilead, for HIV pre-exposure prophylaxis (PrEP) in the US. Taking the antivirals once daily lowers the likelihood of HIV establishing a productive infection in the human host. 4 Clinical trials have shown this treatment

2017 Canadian Agency for Drugs and Technologies in Health - Environmental Scanning

14. HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies

HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies | CADTH.ca CADTH Document Viewer HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil Fumarate — Regulatory and Reimbursement Policies Table of Contents Search this document HIV Pre-Exposure Prophylaxis with Emtricitabine/Tenofovir Disoproxil (...) of high-risk sexual encounters — precautions that may not be accepted by some individuals. This situation changed in 2012 with the FDA approval and availability of the fixed-dose antiviral combination emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) Truvada, manufactured by Gilead, for HIV pre-exposure prophylaxis (PrEP) in the US. Taking the antivirals once daily lowers the likelihood of HIV establishing a productive infection in the human host. 4 Clinical trials have shown this treatment

2017 Canadian Agency for Drugs and Technologies in Health - Environmental Scanning

15. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance UPDATED RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV JULY 2018 POLICY BRIEF HIV TREATMENT – INTERIM GUIDANCE @WHO/SEARO Gary HamptonWHO/CDS/HIV/18.18 © World Health Organization 2018 Some rights reserved (...) the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance. Geneva: World Health Organization; 2018 (WHO/CDS/HIV/18.18). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales

2018 World Health Organisation HIV Guidelines

16. Emtricitabine/Tenofovir for Post-Exposure Prophylaxis Against HIV: A Review of Clinical Effectiveness and Cost-Effectiveness

Emtricitabine/Tenofovir for Post-Exposure Prophylaxis Against HIV: A Review of Clinical Effectiveness and Cost-Effectiveness Emtricitabine/Tenofovir for Post-Exposure Prophylaxis Against HIV: A Review of Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Emtricitabine/Tenofovir for Post-Exposure Prophylaxis Against HIV: A Review of Clinical Effectiveness and Cost-Effectiveness Emtricitabine/Tenofovir for Post-Exposure Prophylaxis Against HIV: A Review (...) of Clinical Effectiveness and Cost-Effectiveness Published on: March 17, 2017 Project Number: RC0868-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of emtricitabine/tenofovir, with or without integrase strand transfer inhibitors, compared with alternative antiretroviral drug regimens for post-exposure prophylaxis against HIV? What is the cost-effectiveness of emtricitabine/tenofovir, with or without

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

17. Correction: A randomised controlled trial of a telephone administered brief HIV risk reduction intervention amongst men who have sex with men prescribed post-exposure prophylaxis for HIV after sexual exposure in the UK: Project PEPSE. (PubMed)

Correction: A randomised controlled trial of a telephone administered brief HIV risk reduction intervention amongst men who have sex with men prescribed post-exposure prophylaxis for HIV after sexual exposure in the UK: Project PEPSE. [This corrects the article DOI: 10.1371/journal.pone.0216855.].

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2019 PloS one Controlled trial quality: uncertain

18. Pre-exposure prophylaxis of HIV in adults at high risk: Truvada (emtricitabine/tenofovir disoproxil)

Pre-exposure prophylaxis of HIV in adults at high risk: Truvada (emtricitabine/tenofovir disoproxil) Pre-e Pre-exposure proph xposure prophylaxis of HIV in adults at high ylaxis of HIV in adults at high risk: T risk: T ruvada ( ruvada (emtricitabine/tenofo emtricitabine/tenofovir disopro vir disoproxil) xil) Evidence summary Published: 5 October 2016 nice.org.uk/guidance/esnm78 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up (...) -to-date in October 2016. See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA or NICE websites for up-to-date information. Summary This evidence summary reviewed 4 randomised trials of Truvada (emtricitabine/tenofovir disoproxil 200 mg/245 mg) for pre-exposure prophylaxis (PrEP) of HIV in either HIV-negative men or transgender women who have sex with men, or HIV-negative individuals in a heterosexual partnership with a person already infected with HIV

2016 National Institute for Health and Clinical Excellence - Advice

19. Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection - A meta-analysis of data from trials and observational studies of HIV pre-exposure prophylaxis. (PubMed)

Incidence of sexually transmitted infections in men who have sex with men and who are at substantial risk of HIV infection - A meta-analysis of data from trials and observational studies of HIV pre-exposure prophylaxis. Men who have sex with men (MSM) and who engage in condomless anal intercourse with casual partners are at high risk of acquiring sexually transmitted infections (STIs), but reliable epidemiological data are scarce. Studies on HIV pre-exposure prophylaxis (PrEP) enrol MSM who (...) indicate that they engage in behaviour that puts them at high risk of acquiring HIV. Because they also screen for STIs at regular intervals, these studies may serve as a valuable source to estimate incidence rates of STIs in this subpopulation of MSM.We systematically searched for trials and observational studies of PrEP in MSM that reported data on the incidence of STIs during the study period. Incidence rates were calculated as events per 100 person-years (py) with 95% confidence intervals (CI). Data

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2018 PLoS ONE

20. HIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP)

HIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP) Guideline writing group Michael Brady (Co-chair) Consultant in Sexual Health and HIV, King’s College Hospital, London Alison Rodger (Co-chair) Reader and Honorary Consultant Infectious Diseases and HIV, University College London David Asboe Consultant HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London Valentina Cambiano Lecturer in Infectious Disease Modelling and Biostatistics, University (...) on the use of HIV pre-exposure prophylaxis (PrEP) 2018 BHIVA/BASHH guidelines on the use of PrEP 2 Contents 1 Objectives 6 1.1 Inclusivity 6 2 Methods 7 2.1 Search strategy 7 2.2 GRADE system 7 2.2.1 Good practice points 8 2.3 Stakeholder involvement, piloting and feedback 8 2.4 Generic preparations of tenofovir disoproxil 8 2.5 References 8 3 Summary of recommendations 9 4 Evidence for safety and efficacy in key populations 15 4.1 Evidence for safety and efficacy in men who have sex with men (MSM) 15

2018 British HIV Association

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