The effect of prevention methods on reducing sexual risk for HIV and their potential impact on a large-scale: a literature review

Abstract

A spectrum of diverse prevention methods that offer high protection against HIV has posed the following challenge: how can national AIDS policies with high coverage for prevention and treatment make the best use of new methods so as to reverse the current high, and even rising, incidence rates among specific social groups? We conducted a narrative review of the literature to examine the prevention methods and the structural interventions that can have a higher impact on incidence rates in the context of socially and geographically concentrated epidemics. Evidence on the protective effect of the methods against sexual exposure to HIV, as well as their limits and potential, is discussed. The availability and effectiveness of prevention methods have been hindered by structural and psychosocial barriers such as obstacles to adherence, inconsistent use over time, or only when individuals perceive themselves at higher risk. The most affected individuals and social groups have presented limited or absence of use of methods as this is moderated by values, prevention needs, and life circumstances. As a result, a substantial impact on the epidemic cannot be achieved by one method alone. Programs based on the complementarity of methods, the psychosocial aspects affecting their use and the mitigation of structural barriers may have the highest impact on incidence rates, especially if participation and community mobilization are part of their planning and implementation.

Factors Associated With the Consistent Use of the Male Condom Among Women Living With Hiv/Aids

“…The use of such substances may have an influence on the difficulty of reducing new cases of HIV. 3,16 Although it did not observe a statistically significant difference, this study identified that 80.7% of the women who reported an inconsistent use of the condom reported having a fixed partner. The 9/12 male condom has always been the main means of preventing the sexual transmission of HIV, but only the use of this barrier method has become insufficient since its use in all sexual relations is not valued among couples in long-term relationships, as they start to trust one another.…”

“…2 Despite the advances in clinical and pharmacological research, which has resulted in the creation of a set of new effective methods to prevent sexual transmission of HIV, coupled with the fact that Brazil has one of the best HIV/aids prevention and treatment programs in the world, the feminization process of the epidemic was not contained. [3][4] The increase in the incidence of cases in the female population can be verified by the reduction in the sex ratio over the years. In 1986, for every 15 cases among men, there was one case in woman.…”

“…However, despite the advantages and convenience, it has limitations, especially for women, as it provides little autonomy. [2][3]6 Negotiating the use of the male condom is one of the difficulties experienced by the female population. 6 In this context, within the context of combined prevention, there are other prevention alternatives that expand the options, however, the condom remains a fundamental method against sexually transmitted infections (STI) and the HIV infection and their access to the entire population remains crucial especially for the most vulnerable populations.…”

Reincidentes en el cuidado, pero sin derecho a la prevención: un análisis de la oferta de la profilaxis posexposición sexual al VIH en Porto Alegre, Brasil

“…La demanda de uso de la PEP aumentó, principalmente, entre personas que se identifican como gays y hombres que tienen sexo con otros hombres (9,10,11,12) . Uno de los temores señalados con relación a la PEP es la posibilidad de provocar el aumento de prácticas sexuales de riesgo al VIH y el uso repetido de la estrategia (13) .…”

Homens heterossexualmente ativos e gerenciamento do risco de infecção pelo HIV no contexto da profilaxia pós-exposição sexual (PEPsexual): experiências em cinco cidades brasileiras

“…No que tange especificamente aos homens heterossexuais, estes eram menos propensos a procurarem testes de HIV do que os outros homens e mulheres por conta das construções sociais relacionadas à masculinidade hegemônica (BARROS et al, 2017). Ainda assim, no contexto brasileiro, poucos estudos têm se debruçado sobre a TS-HIV entre homens em geral e, mais especificamente entre homens heterossexualmente ativos, apesar de alguns achados qualitativos sugerirem menores taxas de TS-HIV como método preventivo entre brasileiros quando comparado aos homens de países norte-americanos e europeus (GRANGEIRO et al, 2015b;LIU et al, 2014).…”