1. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations
- Author
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Virginia A. Fonner, Caitlin E. Kennedy, Sarah L Dalglish, Florence Koechlin, Ioannis Hodges-Mameletzis, Kevin R. O'Reilly, Robert M. Grant, Michelle Rodolph, and Rachel Baggaley
- Subjects
Oral ,Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Epidemiology and Social ,Anti-HIV Agents ,HIV prevention ,preexposure prophylaxis ,Immunology ,Human immunodeficiency virus (HIV) ,Administration, Oral ,HIV Infections ,Drug resistance ,medicine.disease_cause ,Chemoprevention ,Medical and Health Sciences ,Placebos ,Young Adult ,03 medical and health sciences ,Pre-exposure prophylaxis ,0302 clinical medicine ,systematic review ,Virology ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Young adult ,Adverse effect ,Reproductive health ,business.industry ,Public health ,Psychology and Cognitive Sciences ,HIV ,virus diseases ,Biological Sciences ,030112 virology ,tenofovir ,meta-analysis ,Infectious Diseases ,Meta-analysis ,Administration ,Female ,Pre-Exposure Prophylaxis ,business - Abstract
Objective: Preexposure prophylaxis (PrEP) offers a promising new approach to HIV prevention. This systematic review and meta-analysis evaluated the evidence for use of oral PrEP containing tenofovir disoproxil fumarate as an additional HIV prevention strategy in populations at substantial risk for HIV based on HIV acquisition, adverse events, drug resistance, sexual behavior, and reproductive health outcomes. Design: Rigorous systematic review and meta-analysis. Methods: A comprehensive search strategy reviewed three electronic databases and conference abstracts through April 2015. Pooled effect estimates were calculated using random-effects meta-analysis. Results: Eighteen studies were included, comprising data from 39 articles and six conference abstracts. Across populations and PrEP regimens, PrEP significantly reduced the risk of HIV acquisition compared with placebo. Trials with PrEP use more than 70% demonstrated the highest PrEP effectiveness (risk ratio = 0.30, 95% confidence interval: 0.21–0.45, P
- Published
- 2016
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