Brown, J. L., Sales, J. M., & DiClemente, R. J. Current HIV/AIDS Reports (September 2014), E-publication ahead of print.
To assess the effectiveness of integrated behavioral and biomedical interventions, the authors conducted a literature review on efficacy data and factors associated with the acceptability and uptake of three biomedical HIV prevention approaches: microbicides, pre-exposure prophylaxis (PrEP), and HIV vaccination. They searched online databases to identify published articles in peer-reviewed journals that either (a) provided efficacy data or evaluated the acceptability of microbicides, PrEP, or an HIV vaccine or (b) discussed strategies for optimizing the implementation and dissemination of combination HIV prevention interventions. The study showed that microbicides and HIV vaccination have limited efficacy for HIV prevention, but PrEP has been shown to be effective. The authors noted that while many efficacious biomedical prevention strategies exist, numerous factors may affect their acceptability, uptake, and dissemination among key populations. The review showed that there are no available strategies to effectively incorporate biomedical and behavioral interventions, and identified concerns about the potential negative consequences of biomedical HIV prevention on behavioral prevention interventions, such as condom use. Additionally, challenges such as access to services, cost, and patient comfort can impede dissemination of biomedical HIV prevention methods. The authors called for more research to identify strategies for effectively integrating and evaluating combination HIV prevention interventions, and stressed that these interventions should be tailored to specific populations.