Prevention

Effective HIV prevention intervention includes

• Condom use
  Condoms, when used correctly and consistently, are highly effective in preventing HIV and other sexually transmitted infections (STIs). A large body of scientific evidence shows that male latex condoms have an 80% or greater protective effect against the sexual transmission of HIV and other STIs. Latex condoms are the best way to keep from getting HIV during sex. If you or your partner is allergic to latex, there are condoms made of polyurethane that can protect against HIV, too. But natural membrane condoms, also called lambskin condoms, do not prevent HIV because the virus can pass through them. If a man can’t or won’t use a condom, a woman can use the Reality female condom. It may protect against HIV, but it’s not as good as the latex condom a man uses. Do not use a Reality female condom along with a male condom. Both condoms will not stay in place when used together

• Male circumcision
  Male circumcision is the surgical removal of some or all of the foreskin (or prepuce) from the penis. This can reduce the risk of HIV infection in heterosexual men. However, the individual must continue to use other forms of protection(male condoms/female condoms).

• Provision of clean injecting equipment

• Opioid substitution therapy
  Opioid: analgesic that works by binding to opioid receptors, which are found principally in the central nervous system and the gastrointestinal tract
  Reduce transmission of blood-borne viruses

• Treatment of sexually transmitted infections
  Sexually transmitted infections (STI) have been shown to be important cofactors in the transmission and acquisition of HIV infection. For example, in Rakai, Uganda, research has shown an emergence of genital herpes simplex virus (HSV) in areas with mature HIV epidemics (i.e., areas with a high prevalence of HIV). Investigators found a nearly fivefold association of HSV with HIV-1 acquisition
  Genital ulcers, such as those associated with HSV-2, are potent cofactors in both HIV transmission and acquisition

• HIV testing and counselling
• A set of interventions to prevent mother-to-child transmission of HIV
• Sex education

To educate youth and society of

• Abstinence
• Use of condoms
  In Malaysia
  Reproduction – Form 3
  E.g. in Thailand
  “Condom King”
  Captain Mandela- HIV computer game
  

In health care settings, transmission of HIV can be prevented through

• Primary prevention measures such as blood safety, standard precautions, injection safety, and safe waste disposal

Standard precautions:

• Handwashing (or using an antiseptic handrub)
• Gloves, Masks, goggles, face masks, Gowns, Linen
• Patient care equipment
• Environmental cleaning
• Sharps
• Patient resuscitation
• Patient placement
• Use physical barriers (protective goggles, face masks and aprons)
• Use antiseptic agents for cleansing the skin or mucous membrane
• Use safe work practices such as not recapping or bending needles,
• Safely dispose of infectious waste materials to protect those who
  handle them and prevent injury or spread of infection to the
  community.
• Process instruments, gloves and other items after use by first
  decontaminating and thoroughly cleaning them, then either sterilizingor high-level disinfecting them using the recommended procedures

• Secondary prevention measures, such as post-exposure prophylaxis for occupational or certain non-occupational exposures to HIV such as in health-care settings, post-rape, and in case of condom breakage.

o Post-exposure prophylaxis (PEP) is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure, either occupationally or through sexual intercourse.
o If you are within 72 hours of an incident of possible exposure to HIV, ask for PEP (Post Exposure Prophylaxis) treatment
o PEP treatment can help stop you becoming infected with the virus after you have been exposed to HIV. The sooner treatment is begun the higher the probability the treatment will be effective

In addition, there is increasing evidence indicating that

• ART programmes can be implemented in a way that emphasizes HIV prevention
• Current research on new prevention technologies such as microbicides, topical and oral antiretroviral pre-exposure prophylaxis in preventing the transmission of HIV and AIDS vaccines is ongoing.

Microbicides: compounds that can be applied inside the vagina or rectum to protect against sexually transmitted infections (STIs) including HIV.

HIV prevention - combination behavioural change approach has been
labelled as ABC—i.e.,

>Abstinence, including delay of sexual initiation or debut

>Being safer by being faithful to one’s partner or reducing the number of sexual partners

>correct and consistent Condom use

References:

1. Centers World Health Organization
http://www.who.int/hiv/topics/prevention/en/

2. Malaysian Aids Council
http://www.mac.org.my/hmtct.htm

3. Food and Drug Administration
http://www.fda.gov/opacom/lowlit/aids.pdf

4. Centers for Disease Control and Prevention
http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
http://www.reproline.jhu.edu/english/4morerh/4ip/IP_manual/02_StandardPrecaution.pdf