About this Research Topic

Background

Background
Despite significant progress toward 95-95-95 milestones, 2022 HIV incidence estimates remained well above targets specified by UNAIDS, underscoring broad unmet needs for primary HIV prevention. Scale-up of prevention strategies to date has yielded mixed results, with the most notable and significant missed opportunities in oral pre-exposure prophylaxis (PrEP). HIV oral PrEP is safe and up to 99% effective when taken as directed but remains inaccessible and/or underutilized by most. While HIV programming must continue to guarantee diagnosis and treatment services for all in need, sustainable investments in primary prevention, despite financing constraints, are critical to close remaining epidemic control gaps.

Goal
Identical to diagnosis, treatment and viral suppression targets, UNAIDS specifies that 95% of people at risk of HIV must access effective HIV combination prevention options. This collection intends to curate policy and programming best practices and innovations that improve and measure the effectiveness of prevention method use, coverage, and impact, particularly as the PrEP method mix expands to include longer-acting formulations and a more comprehensive range of delivery models. Increasing the evidence base is intended to improve implementation efficiencies and compel policy changes conducive to sustainable, adaptable, and agile programming, all within the context of universal health coverage and integrated people-centered care to meet the present imperative for primary prevention. Most importantly, evidence is needed to articulate the why and the how of investing in sustainable, community-driven and led HIV prevention programming to preserve the gains made in the epidemic. HIV prevention has been vastly under-resourced, and investments must be grown to accomplish overall goals.

Scope and Information
This collection will bring together original research, reviews, and commentaries highlighting emerging opportunities to accelerate and expand access to effective primary HIV prevention among populations with persistent, high HIV incidence. The collection seeks contributions to innovations in program strategy and execution that maximize prevention coverage through behavioural, health systems, and policy-level levers. The Research Topic will prioritize submissions that novel supply- and demand-side interventions that increase awareness and support for practical use, access, uptake, and use aligned with needs and risks. In particular, de-medicalized, integrated and differentiated approaches to delivery, such as the use of telemedicine, community-based/led, private sector including pharmacies, and self-care models yielding lessons for expanding the standards of care for biomedical prevention delivery, are of interest. Novel approaches to measurement and research that reflect the highly dynamic nature of risk and nuanced use decisions are also encouraged, especially those designed for adolescents and other populations that experience challenges aligning method use and HIV risk. Given the expanding biomedical method mix but constrained resources, novel and best practice prevention product introduction approaches that support enhanced decision-making are of interest. In addition, data or actual case studies to support investment cases in specific and/or overall cost-effective HIV prevention modalities and strategies to close remaining epidemic control gaps are encouraged for submission.

Topic Editor Kenneth Ngure received financial support from National Institutes of Health, USA; Bill and Melinda Gates Foundation and MSD (Merck Investigator Studies Program).

Please note that the submission of an abstract for the abstract deadline is not mandatory. The abstract can be also an informal summary or concept of the intended manuscript submission to gain initial feedback from the Topic Editor team. These can be submitted on a rolling basis for consideration from now until that deadline. Please also note that this Research Topic has a rolling publication, and accepted manuscripts will be published online immediately.

Keywords: HIV, HIV prevention, HIV incidence, health systems, HIV delivery, HIV risk

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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