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Prevention of Transmission
Prevention of HIV/AIDS transmission has attracted a lot of attention, but it isnŐt always all that effective, and the long term health benefits are rarely compared with the negative effects of the interventions.
“More research is needed to determine the degree to which the viral load in blood predicts the risk of HIV transmission and to determine the association between the viral load in blood and the viral load in semen and vaginal secretions”
Antiretroviral therapy and sexual transmission of HIV. UNAIDS. 2008 Feb 1
“At 12 weeks, among infants who were not infected at birth, 24 (7.9%) infections occurred in the NVP [Nevirapine] arm and 41 (13.1%) in the ZDV [AZT] arm”
Gray GE et al. A randomized trial of two postexposure prophylaxis regimens to reduce mother-to-child HIV-1 transmission in infants of untreated mothers. AIDS. 2005 Aug 12;19(12):1289-97.
“Multiple use of nonoxynol-9 [as a vaginal microbicide] could cause toxic effects enhancing HIV-1 infection. This drug can no longer be deemed a potential HIV-1-prevention method.”
Van Damme L et al. Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial. Lancet. 2002 Sep 28;360(9338):9338.
“Detection of HIV infection occurred in 19 newborns, 9 (1.4%) of 631 deliveries in the nevirapine arm and 10 (1.6%) of 617 deliveries in the placebo arm”
Dorenbaum A et al. Two-dose intrapartum/newborn nevirapine and standard antiretroviral therapy to reduce perinatal HIV transmission: a randomized trial. JAMA. 2002 Jul 10;288(2):189-98.
“low serum vitamin A concentrations were shown [in several papers] to be associated with an increased risk of vertical HIV transmission in prospective cohort studies, randomized, placebo-controlled trials have reported that vitamin A and other vitamin supplements do not appeare to have an effect on HIV transmission during pregnancy or the intrapartum period…A higher serum vitamin A concentration was also associated with a lower infant mortality rate among the offspring of this population of HIV-infected mothers…Use of multivitamin and mineral supplements by low income pregnant women in the United States is associated with a 41% reduction in the risk of low birth weight and a 34% reduction in the risk of preterm birth…prenatal Vitamin A supplementation of HIV-infected women reduced the risk of preterm birth by 34% in South Africa and the risk of low birth weight by 30% in Malawi.”
Dreyfuss ML, Fawzi WW. Micronutrients and vertical transmission of HIV-1. Am J Clin Nutr. 2002 Jun;75(6):959-70.
http://www.ajcn.org/cgi/content/abstract/75/6/959
http://www.ajcn.org/cgi/content/abstract/75/6/959
Courtesy Alberta Reappraising AIDS Society, December 22, 2008.