About this Research Topic
Evidence from randomized trials has demonstrated the efficacy of the use of antiretroviral drugs (ARVs) as pre-exposure prophylaxis (PrEP) of HIV infection in HIV-negative men and women in Botswana, HIV-serodiscordant couples in Kenya, people who inject drugs in Thailand, and men who have sex with men and transgender women in sites across North-America, South America, Asia and Africa, as well as the United Kingdom and France. PrEP holds much promise to contribute to curbing HIV epidemics in key populations, in particular as part of comprehensive combination prevention approaches. PrEP may be particularly important in preventing HIV transmission from partners with as yet undiagnosed HIV infection, which likely accounts for a major share of new diagnoses globally. However, despite World Health Organization recommendations and much enthusiasm amongst HIV prevention experts, community activists and, more recently, also policy makers in some countries, access to PrEP remains limited in most parts of the world.
Importantly, while ARVs are registered for use as PrEP in an increasing number of countries, there is hesitation from government and other funders, such as health insurance providers, to subsidize PrEP as currently existing in the United States, France and Norway. Elsewhere, demonstration projects and targeted access programs are nevertheless emerging to make PrEP available for HIV prevention in key populations. These projects and programs are concerned with a wide range of implementation issues, including appropriate access models and regulatory arrangements; potential user awareness, interest and uptake; user experiences, patterns of pill-taking and sexual behaviours; implications and insights for HIV prevention programming, impact and cost; information sharing regarding obtaining access for formal or informal use, in particular through social media; and social attitudes regarding PrEP use and users.
Despite burgeoning PrEP implementation activities, evidence and understandings of effective approaches in diverse settings remains limited. The purpose of the Research Topic is provide an interactive platform for knowledge exchange and developing shared learnings that will advance access to PrEP for those who would benefit globally. For this Research Topic we encourage contributions that address these and other pertinent issues related to making PrEP accessible for key populations in community settings worldwide. The Research Topic is open to Category A and B contributions, in particular long and short articles reporting original research, reviews, cases or perspectives. We encourage contributions from a diversity of health and social science disciplines, including but not limited to public health, sociology, anthropology and psychology, as well as fields of research, including but not limited to those concerned with health services, health policy and health behaviour. We welcome contributions from different country, resource and cultural settings, including from the global south, from regional, rural and remote areas and regarding indigenous and ethnic, gender and sexual minority population groups.
Keywords: HIV, pre-exposure prophylaxis, key populations, implementation, MSM, gay men, people who inject drugs, sex workers, policy, access, combination prevention, prevention, antiretroviral drugs, PrEP, ARV
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