Given financial constraints, it would be unethical to divert antiretroviral drugs from treatment to prevention

Health Affairs

Volumn 31, Issue 7, 2012, Pages 1537-1544

  Macklin, Ruth ^a   Cowan, Ethan ^a  

^a ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTI HUMAN IMMUNODEFICIENCY VIRUS AGENT; MICROBICIDE; PLACEBO;

ACQUIRED IMMUNE DEFICIENCY SYNDROME; ANTIVIRAL THERAPY; ARTICLE; BUDGET; DISEASE TRANSMISSION; ENVIRONMENTAL PROTECTION; FINANCIAL MANAGEMENT; HEALTH CARE POLICY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENT; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFECTION PREVENTION; PRACTICE GUIDELINE;

ANTI-HIV AGENTS; DRUG COSTS; ETHICS, MEDICAL; HEALTH EXPENDITURES; HEALTH POLICY; HEALTH PRIORITIES; HIV INFECTIONS; HUMANS; RESOURCE ALLOCATION;

EID: 84866270155     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.0071     Document Type: Article

References (22)

1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493-505.
2. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363(27):2587-99.
3. University of Washington, International Clinical Research Center [Internet]. Seattle (WA): University of Washington. Press release, Pivotal study finds that HIV medications are highly effective as prophylaxis against HIV infection in men and women in Africa; 2011 Jul 13 [cited 2012 Apr 29]. Available from: http://depts.washington.edu/ uwicrc/research/studies/files/ PrEP_PressRelease-UW_ 13Jul2011.pdf
4. Centers for Disease Control and Prevention, National Center for HIV/AIDS [Internet]. Atlanta (GA): CDC. Press release, CDC trial and another major study find PrEP can reduce risk of HIV infection among heterosexuals; 2011 Jul 13 [cited 2012 Apr 29]. Available from: http:// www.hanc.info/resources/ Documents/CDC%20TDF2%20 Media%20Materials.pdf
5. Microbicide Trials Network. MTN Statement on decision to discontinue use of tenofovir gel in VOICE, a major HIV prevention study in women [Internet]. Pittsburgh (PA): MTN; 2011 Nov [cited 2012 Apr 29]. Available from: http:// www.mtnstopshiv.org/node/3909
6. Rerks-Ngarm S, Pitisuttithum P, Nitayaphan S, Kaewkungwal J, Chiu J, Paris R, et al. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med. 2009;361(23):2209-20.
7. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168-74.
8. Joint United Nations Programme on HIV/AIDS. Global Report fact sheet: the global AIDS epidemic [Internet]. Geneva: UNAIDS; 2010 Nov [cited 2012 Apr 29]. Available from: http:// www.unaids.org/en/media/unaids/ contentassets/documents/ factsheet/2010/20101123_FS_ Global_em_en.pdf
9. Macklin R. Ethics and equity in access to HIV treatment-3 by 5 initiative [Internet]. Geneva: Joint United Nations Programme on HIV/ AIDS; 2004 Jan [cited 2012 Apr 29]. Available from: http://www.who .int/ethics/en/backgroundmacklin. pdf
10. Brock DW. Fairness and health. In: Murray CJL, editor. Summary measures of population health: concepts, ethics, measurement, and applications. Geneva: World Health Organization; 2002. p. 717-26.
11. Brock DW. Separate spheres and indirect benefits. Cost Eff Resour Alloc. 2003;1(1):6.
12. Kamm FM. Morality, mortality. New York (NY): Oxford University Press; 1993.
13. Brock DW. Priority to the worse off in health-care resource prioritization. Oxford (UK): Oxford University Press; 2002.
14. Brock DW, Wikler D. Ethical challenges in long-term funding for HIV/ AIDS. Health Aff (Millwood). 2009;28(6):1666-76.
15. Daniels N. Accountability for reasonableness. BMJ. 2000;321(7272): 1300-1.
16. Daniels N. Fair process in patient selection for antiretroviral treatment in WHO's goal of 3 by 5. Lancet. 2005;366(9480):169-71.
17. Ashcroft R. Fair process and the redundancy of bioethics: a polemic. Public Health Ethics. 2008;1(1):3-9.
18. Marseille E, Hofmann PB, Kahn JG. HIV prevention before HAART in sub-Saharan Africa. Lancet. 2002;359(9320):1855.
19. Sepúlveda J, Carpenter C, Curran J, Holzemer W, Smits H, Scott K, et al. editors. PEPFAR implementation: progress and promise. Washington (DC): National Academies Press; 2007.
20. Office of the US Global AIDS Coordinator. The U.S. President's Emergency Plan for AIDS Relief: fiveyear strategy [Internet]. Washington (DC): The Office; [cited 2012 Apr 29]. Available from: http:// www.pepfar.gov/documents/ organization/133035.pdf
21. International Center for AIDS Care and Treatment.Wafaa El-Sadr argues for " treatment as prevention" in World Bank and USAID debate. ICAP News [Internet]. New York (NY): ICAP; 2011 Nov [cited 2012 Apr 29]. Available from: http://www .columbia-icap.org/news/icapnews/ Nov11News/Nov11News.html
22. United States President's Emergency Plan for AIDS Relief. Prevention [Internet]. Washington (DC): Office of the US Global AIDS Coordinator; [cited 2012 Apr 29]. Available from: http://www.pepfar.gov/strategy/ prevention_care_treatment/ 133293.htm