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ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Preventing HIV and HSV 2:What will it take?
The oral presentations during this session were excellent and should be available very soon.
They included the Proud Study from the UK, On-demand PrEP with oral TDC-FTC in MSM - results of the ANRS Ipergay Trial, The Demonstration Project of PrEP and ART, Scale-up Pre-exposure Prophylaxis in San Francisco to impact HIV incidence, the FACTS 001 Phase 3 Trial of Pericoital Tenoforvir 1% gel for HIV Prevention in Women, the Effect of oral and gel Tenofovir on Genital HSV Shedding in immunocompetent Women, Injectable Hormonal Contraception Use and Women's Risk for HSV 2 Acquisition, Medical Male Circumcision of HIV -Infected Men reducing long term penile HIV shedding.
There are some exciting results from these studies which may impact what is happening in Australia.
From a sexual health point of view, I note with interest the study where consistent DMPA use may increase women's risk of HSV2 acquisition. Obviously as pointed out, evaluation in larger populations with more frequent follow up is needed. It was also important that they pointed out that the issue of increased HIV and HSV-2 associated with DMPA needed to be weighed against benefits, reduced risk maternal mortality and unwanted pregnancy.
I intend to report back more on the session on Hormonal Contraception and HIV in Women.
It was also very useful to revisit yet again the issue of medical male circumcision where the study concerned noted penile shedding of HIV increasing at 1-2 weeks after medical circumcision in ART naive men but then, penile HIV shedding became significantly lower after wound healing later. They concluded that suppressive ART decreased number of HIV shedding events and quantity of HIV shedding during would healing. There was re-enforcemnt of the long term benefits of MC in HIV positive men reducing penile HIV shedding. However the importance of prevention of HIV transmission to partners during immediate post surgical period was emphasised. Initiating ART at time of MC reduced male to female HIV transmission risk. Implications in Australia???