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HIV prevention cascades: A unifying framework to replicate the successes of treatment cascades

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Title: HIV prevention cascades: A unifying framework to replicate the successes of treatment cascades
Authors: Schaefer, R
Gregson, S
Fearon, E
Hensen, B
Hallett, T
Hargreaves, JR
Item Type: Journal Article
Abstract: Many countries are off track to meet targets for reduction of new HIV infections. HIV prevention cascades have been proposed to assist in the implementation and monitoring of HIV prevention programmes by identifying gaps in the steps required for effective use of prevention methods, similar to HIV treatment cascades. However, absence of a unifying framework impedes widespread use of prevention cascades. Building on a series of consultations, we propose an HIV prevention cascade that consists of three key domains of motivation, access, and effective use in a priority population. This three step cascade can be used for routine monitoring and advocacy, particularly by attaching 90-90-90-style targets. Further characterisation of reasons for gaps across motivation, access, or effective use allows for a comprehensive framework that guides identification of relevant responses and platforms for interventions. Linkage of the prevention cascade, reasons for gaps, and interventions reconciles the different requirements of prevention cascades, providing a unifying framework.
Issue Date: 1-Jan-2019
Date of Acceptance: 12-Nov-2018
URI: http://hdl.handle.net/10044/1/66371
DOI: https://dx.doi.org/10.1016/S2352-3018(18)30327-8
ISSN: 2405-4704
Publisher: Elsevier
Journal / Book Title: The Lancet HIV
Volume: 6
Issue: 1
Copyright Statement: © 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Wellcome Trust
Medical Research Council (MRC)
Bill & Melinda Gates Foundation
Bill & Melinda Gates Foundation
Medical Research Council (MRC)
Funder's Grant Number: 084401/Z/07/Z
MR/K010174/1B
OPP1084364
OPP1161471
MR/R015600/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
PREEXPOSURE PROPHYLAXIS
CARE
MEN
SEX
Publication Status: Published
Online Publication Date: 2019-01-07
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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