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[Comment] NextGen HIV prevention: new possibilities and questions

In less than a decade, HIV prevention has evolved from a reliance on education, behavioural interventions, and use of condoms to focusing on the optimum use of antiretrovirals to suppress infectiousness and for primary prophylaxis. Landmark studies have shown the efficacy of the early initiation of treatment for people infected with HIV,1 and the use of oral pre-exposure prophylaxis (PrEP) for those at highest risk to decrease HIV transmission.2 Despite PrEP being shown to be efficacious in most trials in which it was assessed, the paramount importance of consistent use of preventive medication was shown when oral and topical tenofovir-based regimens did not show efficacy in three studies involving young African women, primarily because of suboptimum adherence.

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