Hiv Treatments As Prevention Tasp

​HIV Treatment as Prevention: Primer for Behavior-Based Implementation provides the first practical guide to integrating behavioral prevention with antiretroviral therapies for people living with HIV infection. This brief book discusses the historical and social context embedding the shifting landscape in HIV prevention, where the use of effective treatments have become the focus of HIV prevention. While using treatments for prevention is promising, the history of HIV prevention offers several important pitfalls that must be avoided if HIV treatments are to ultimately succeed in preventing new HIV infections. Lessons learned from the successes and failures of other biomedical technologies used in HIV prevention, specifically syringes, condoms, and HIV testing are critical to the success of using HIV treatments for prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation summarizes the scientific evidence for advancing the use of antiretroviral therapies for HIV prevention. The evidence makes clear that HIV treatments can prevent HIV transmission, but will fail if behavioral aspects of treatment and HIV transmission are ignored. Of greatest concern are medication adherence and risks for contracting other sexually transmitted infections. Placing HIV treatment within the context of behavioral interventions for maintaining medication adherence and reducing sexual risk behaviors is therefore essential to the future of HIV prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation highlights two pioneering behavioral interventions aimed at maximizing the effects of antiretroviral therapies for preventing HIV transmission. One of the interventions, developed by the Author’s research team, is discussed in detail and the intervention manual is included as an Appendix.

This edited collection brings together the social dimensions of three key aspects of recent biomedical advance in HIV research: Treatment as Prevention (TasP), new technologies such as Pre-Exposure Prophylaxis (PrEP), and the Undetectable equals Untransmittable (U=U) movement. The growth of new forms of biomedical HIV prevention has created hope for the future, signalling the possibility of a world without AIDS. In this context, the volume discusses the profound social, political and ethical dilemmas raised by such advances, which are to do with readiness, access, equity and availability. It examines how HIV prevention has been, and is, re-framed in policy, practice and research, and asks: How best can new biomedical technologies be made available in a profoundly unequal world? What new understandings of responsibility and risk will emerge as HIV becomes a more manageable condition? What new forms of blame will emerge in a context where the technologies to prevent HIV exist, but are not always used? How best can we balance public health’s concern for adherence and compliance with the rights of individuals to decide on what is best for themselves and others? Few of these questions have thus far received serious consideration in the academic literature. The editors, all leaders in the social aspects of HIV, have brought together an innovative and international collection of essays by top thinkers and practitioners in the field of HIV. This book is an important resource for academics and professionals interested in HIV research. Chapters "Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland’s PrEP Journey", "How the science of HIV treatment-as-prevention restructured PEPFAR’s strategy: The case for scaling up ART in ‘epidemic control’ countries", "Stigma and confidentiality indiscretions: Intersecting obstacles to the delivery of Pre-Exposure Prophylaxis to adolescent girls and young women in east Zimbabwe" and "The drive to take an HIV test in rural Uganda: a risk to prevention for young people?" are available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

​HIV Treatment as Prevention: Primer for Behavior-Based Implementation provides the first practical guide to integrating behavioral prevention with antiretroviral therapies for people living with HIV infection. This brief book discusses the historical and social context embedding the shifting landscape in HIV prevention, where the use of effective treatments have become the focus of HIV prevention. While using treatments for prevention is promising, the history of HIV prevention offers several important pitfalls that must be avoided if HIV treatments are to ultimately succeed in preventing new HIV infections. Lessons learned from the successes and failures of other biomedical technologies used in HIV prevention, specifically syringes, condoms, and HIV testing are critical to the success of using HIV treatments for prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation summarizes the scientific evidence for advancing the use of antiretroviral therapies for HIV prevention. The evidence makes clear that HIV treatments can prevent HIV transmission, but will fail if behavioral aspects of treatment and HIV transmission are ignored. Of greatest concern are medication adherence and risks for contracting other sexually transmitted infections. Placing HIV treatment within the context of behavioral interventions for maintaining medication adherence and reducing sexual risk behaviors is therefore essential to the future of HIV prevention. HIV Treatment as Prevention: Primer for Behavior-Based Implementation highlights two pioneering behavioral interventions aimed at maximizing the effects of antiretroviral therapies for preventing HIV transmission. One of the interventions, developed by the Author’s research team, is discussed in detail and the intervention manual is included as an Appendix.

Treatment as prevention® (TasP®) proposes a new way to end AIDS by requiring people living with HIV/AIDS (PWAs) to strictly adhere to lifelong HIV treatment, effectively making them non-infectious. Essentially, TasP attempts to stop the spread of HIV at the source. Yet, this radical prevention intervention is not without individual and collective repercussions. With an eye to the growing physical, moral, legal, and political costs of HIV treatment on adherence, this study seeks to describe how adherence has changed throughout the AIDS epidemic in order to understand its function in this present time and place of TasP in Vancouver. Through a Foucauldian genealogy, this dissertation examines how TasP adherence practices re-asserts colonial hierarchies. Guided by critical race and postcolonial theories, I argue that race and racism distinguish those who are made to live from those left to die in this new war on AIDS, a war against PWAs. Using biopower as an analytical framework, I emphasize the continued role of sovereign power, a repressive power alongside productive power. To examine adherence, I investigate specific moments in time and across place to ground Vancouver's current TasP rationale and practices, beginning with the scientific role and methods of late 19th century colonial medicine through to present day TasP. I delve into TasP's scientific rationale by analyzing the first uses of antiretroviral treatment for HIV prevention. Next, I outline the changes in British Columbia's public health law along with Vancouver's clinical guidelines and protocols. Then, I position artwork produced by PWAs as important sites of knowledge, providing insight into the multiple effects of antiretroviral therapy. To conclude, I argue that TasP works as an imperial formation as it uses force in the construction of its subjects. I suggest TasP pushes us to confront this ethical question: to what end and at whose expense are we willing to end AIDS? At its most basic level, this project seeks to disrupt the seemingly neutral scientific language of TasP by showing how scientific knowledge regarding adherence practices draw from histories relying on, recuperating, and revising the interlocking structures of colonialism, racism, sexism, poverty, and sexuality.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

This edited collection brings together the social dimensions of three key aspects of recent biomedical advance in HIV research: Treatment as Prevention (TasP), new technologies such as Pre-Exposure Prophylaxis (PrEP), and the Undetectable equals Untransmittable (U=U) movement. The growth of new forms of biomedical HIV prevention has created hope for the future, signalling the possibility of a world without AIDS. In this context, the volume discusses the profound social, political and ethical dilemmas raised by such advances, which are to do with readiness, access, equity and availability. It examines how HIV prevention has been, and is, re-framed in policy, practice and research, and asks: How best can new biomedical technologies be made available in a profoundly unequal world? What new understandings of responsibility and risk will emerge as HIV becomes a more manageable condition? What new forms of blame will emerge in a context where the technologies to prevent HIV exist, but are not always used? How best can we balance public health's concern for adherence and compliance with the rights of individuals to decide on what is best for themselves and others? Few of these questions have thus far received serious consideration in the academic literature. The editors, all leaders in the social aspects of HIV, have brought together an innovative and international collection of essays by top thinkers and practitioners in the field of HIV. This book is an important resource for academics and professionals interested in HIV research. Chapters "Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland's PrEP Journey", "How the science of HIV treatment-as-prevention restructured PEPFAR's strategy: The case for scaling up ART in 'epidemic control' countries", "Stigma and confidentiality indiscretions: Intersecting obstacles to the delivery of Pre-Exposure Prophylaxis to adolescent girls and young women in east Zimbabwe" and "The drive to take an HIV test in rural Uganda: a risk to prevention for young people?" are available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

This book concerns HIV prevention. In it the authors argue that until the world focuses its attention on the social issues carried and revealed by AIDS, it is unlikely that HIV transmission will be eradicated or even significantly reduced. The book argues that we are currently witnessing the remedicalisation or the continuing biomedicalisation of HIV prevention, which began in earnest after the development of successful HIV treatment, and that this biomedical trajectory continues with the increasing push to use HIV treatments as prevention, undermining what has been in many countries a successful prevention response. This wide-ranging study argues that HIV prevention involves enabling people and communities to discuss sex, sexuality and drug use and, informed by these discussion, devising locally effective strategies for promoting safe sexual and drug injection practices.

These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.

In 2010, the government of British Columbia (B.C.) dedicated $48 million to stop the spread of HIV. The STOP HIV/AIDS pilot project promotes the uptake of HIV testing in the general population, and the use of antiretroviral therapy amongst those living with HIV/AIDS. This project operates with the rationale of 'treatment as prevention' (TasP), meaning that antiretroviral therapy is beneficial for the person living with HIV/AIDS, and has the secondary benefit of reducing the spread of HIV in the general population. Public health discourses are constructed via particular worldviews and involve the creation and delineation of societal problems. Undertaking a discourse analysis, I identify eight dominant discourses of TasP and STOP HIV/AIDS that include: provincial and international support for TasP and lack of federal leadership in HIV/AIDS; TasP, a 'paradigm shift' and a 'game changer;' TasP as beneficial to the individual and society; human rights and harm reduction; proof and certainty; failure of current prevention efforts; risk discourses; and, finally, universal treatment. I also identify five alternative discourses: holistic understanding/social determinants of health; stigma and discrimination; rights discourse: GIPA, informed consent and self-determination; coercion/criminalization and alternative risk discourse. Through a lens of governmentality, I explicate two overarching and simultaneous discursive strategies in realizing the objective of decreasing the spread of HIV in B.C. The first strategy acts on individuals living with HIV/AIDS, encouraging individuals to take up antiretroviral therapy. The second strategy acts on the general population, informing the population that HIV is a problem, and that treating people living with HIV/AIDS is the best way to protect society as a whole. There are various techniques within these two strategies. These discursive events have immense consequences for the uptake of health policies and programs by the public. The dominant and alternative discourses of TasP impact HIV policy and practice and specifically the individuals living with HIV and AIDS who are the subjects and targets of these initiatives.