HIV Prevention

Question 1

How can we reduce HIV acquisition?

Answer 1

Undetectable viral loads
VMMC - reduces risk by 60% in heterosexual men
Pre-exposure prophylaxis
Post exposure prophylaxis

Question 2

Who does the WHO recommended PrEP be offered to?

Answer 2

All key populations

Question 3

What is the PrEP regime?

Answer 3

TDF alone if with 3TC

Start a week prior to exposure and continue 1 month after

Question 4

What is the PEP regime?

Answer 4

Start asap (no benefit after 72hrs)
First aid - bleed freely, irrigate with water
TDF + 3TC/FTC +DTG for 28days
Use condoms
Test for HepB
HIV test in 3months
Perform risk assessment if occupational

Question 5

What is the PEP regime for low risk infants?

Answer 5

Nevirapine for 6weeks

Question 6

Which infants are high risk of HIV?

Answer 6

If mum

• got <4wks ART pre delivery
• has VL>1000 in 4wks pre delivery
• identified as HIV +ve for first time during breastfeeding

Question 7

What is the PEP regime for high risk infants?

Answer 7

AZT + NVP for 6wks

If breastfeeding then should have a further 6wks (can just be NVP)

Question 8

What are the HIV key populations?

Answer 8

Sex workers and their clients 
IVDU
MSM
Transgender 
Partners of the above

Question 9

What percentage of new HIV infections of key populations account for?

Answer 9

54% globally

99% in E Europe and Central Asia
95% Middle East and N Africa
25% E and S Africa

Question 10

What were the targets of the UNAIDS fast track to end AIDS strategy?

Answer 10

90-90-90
0 new HIV infections in children
90% have access to combination prevention services
27mill more men have VMMC in high prev
90% of key pops have access to HIV combo prevention services
90% don’t report discrimination
90% women don’t report gender inequality