What does the International Antiviral Society-USA (IAS-USA) recommend for HIV prevention in adolescents and adults?

Updated: Jul 01, 2019
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In July 2014, the International Antiviral Society-USA (IAS-USA) released new recommendations for HIV prevention in adolescents and adults in clinical care settings [155, 119] in conjunction with updated recommendations on antiretroviral treatment (ART) of adult HIV infection. [119, 120]

The IAS-USA panel suggested that combined biomedical/behavioral approaches to HIV prevention in clinical settings have the potential to not only prevent the disease but also cause nearly all HIV-infected individuals to become noninfectious. [155, 119] Among its key HIV-prevention recommendations for teens and adults are the following [155, 119] :

  • Perform HIV testing at least once for all adults and adolescents; repeat testing often for those at increased risk.

  • Be vigilant for potential HIV infection, and promptly perform diagnostic testing in those with suspected acute HIV infection.

  • For HIV-confirmed patients, provide multimodal interventions to include prompt initiation of ART, support for treatment adherence, individualized risk assessment and counseling, assistance with partner notification, and periodic screening for common sexually transmitted infections.

  • For high-risk, HIV-uninfected patients, administer preexposure prophylaxis with daily emtricitabine/tenofovir disoproxil fumarate and provide multimodal interventions (eg, individualized counseling on risk reduction).

  • Provide intravenous/injection drug users with multimodal harm reduction services such as access to needle/syringe exchange programs, supervised injection, medically assisted therapies, and detoxification programs.

  • Administer prompt postexposure prophylaxis in individuals with mucosal/parenteral HIV exposure from a known infected source.


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