Abstract

http://ssrn.com/abstract=1743593
 
 

References (10)



 


 



Ethical Allocation of Preexposure HIV Prophylaxis


Lawrence O. Gostin


Georgetown University - Law Center - O'Neill Institute for National and Global Health Law

Susan C. Kim


Georgetown University Law Center; Georgetown University - The O'Neill Institute for National and Global Health Law

January 19, 2011

Journal of the American Medical Association, Vol. 305, pp. 191-192, 2011
Georgetown Public Law Research Paper No. 11-16

Abstract:     
Civil society-led movements transformed global AIDS action from deep skepticism about extending anti-retroviral (ARV) treatment in low and middle-income countries to an historic scaling up of treatment towards universal access. The AIDS movement, however, is at an inflection point due to the interplay of key health and economic determinants - the global financial downturn, tight foreign aid budgets, and intense resource competition. Policy makers will now have to consider implementation of a new intervention - pre-exposure prophylaxis (PrEP), which could mean a diversion of ARVs from treatment to prevention. The principle underlying PrEP is that ARVs could prevent HIV infection among people who are HIV-negative and at high risk. Unlike existing prevention strategies such as voluntary counseling and testing (VCT), condoms, and male circumcision, PrEP is a continuous biomedical intervention.

Although it will take several years to fully establish the clinical efficacy of PrEP in varying populations, the encouraging early results from CAPRISA, iPrEx, and CDC 4323 have accelerated global dialogue on its proof of deliverability. The studies encompass diverse populations, including injecting drug users (IDUs), MSM, serodiscordant heterosexual couples, and sex workers. These studies will be completed at different times, raising the question: if a trial demonstrates effectiveness for a given study group, should PrEP be used for others? The ethical issues raised by PrEP are difficult, but not insurmountable. Examining comparative cost-effectiveness, good governance, overcoming access barriers, and ensuring quality improvement would help ensure ethical allocation under circumstances of scarcity.

Number of Pages in PDF File: 3

Keywords: AIDS (Disease), HIV Prevention, Medical Policy, Public Health

JEL Classification: K00, K32, I10, I18

Accepted Paper Series


Download This Paper

Date posted: January 20, 2011  

Suggested Citation

Gostin, Lawrence O. and Kim, Susan C., Ethical Allocation of Preexposure HIV Prophylaxis (January 19, 2011). Journal of the American Medical Association, Vol. 305, pp. 191-192, 2011 ; Georgetown Public Law Research Paper No. 11-16. Available at SSRN: http://ssrn.com/abstract=1743593

Contact Information

Lawrence O. Gostin (Contact Author)
Georgetown University - Law Center - O'Neill Institute for National and Global Health Law ( email )
600 New Jersey Avenue, NW
Washington, DC 20001
United States
202-662-9038 (Phone)
202-662-9055 (Fax)
Susan C. Kim
Georgetown University Law Center ( email )
600 New Jersey Avenue, NW
Washington, DC 20001
United States
Georgetown University - The O'Neill Institute for National and Global Health Law ( email )
600 New Jersey Avenue, NW
Washington, DC 20001
United States
Feedback to SSRN


Paper statistics
Abstract Views: 237
Downloads: 45
References:  10

© 2014 Social Science Electronic Publishing, Inc. All Rights Reserved.  FAQ   Terms of Use   Privacy Policy   Copyright   Contact Us
This page was processed by apollo4 in 0.359 seconds