Combating HIV/AIDS: Biomedical Approaches Towards Prevention

Biomedical Approaches Towards Prevention


  • Lucy Wangari Mwangi University of Nairobi, Kenya
  • Julie Lajoie University of Manitoba, Winnipeg, Canada
  • Julius O. Oyugi University of Nairobi, Kenya
  • Keith R. Fowke University of Manitoba, Winnipeg, Canada


HESN, Immune quiescence, inflammation, microbicide, treatment-as-prevention, vaccine


For over three decades, HIV/AIDS has had a deleterious impact on public health the world over. There is still no cure for the disease although preventive strategies have evolved over the years to reduce its impact. In addition to behavioural change approaches, biomedical interventions have played a major part in reduction of HIV transmission and subsequently the burden associated with the HIV/AIDS disease. Early biomedical approaches include physical barriers such as condoms, use of clean injection equipment for intravenous drug users, blood and blood product screening. More recently, medical male circumcision and use of anti-retroviral drugs for prevention have been introduced. While these interventions have had a fundamental impact in reducing HIV incidence, the burden in many populations remains. Therefore, there is need to develop new biomedical methods to argument existing efforts. Future biomedical approaches may for instance include use of compounds that modulate the body’s immune system, such as acetylsalicylic acid, to cause resistance to HIV infection. Such approaches could be added to the HIV prevention toolkit.



Abdool Karim, Q. et al. (2010) ‘Effectiveness and Safety of Tenofovir Gel, an Antiretroviral Microbicide, for the Prevention of HIV Infection in Women’, Science, 329(5996), p. 1168 LP-1174. Available at:

Achilles, S. L. et al. (2002) ‘Microbicide efficacy and toxicity tests in a mouse model for vaginal transmission of Chlamydia trachomatis’, Sexually transmitted diseases. LWW, 29(11), pp. 655–664.

‘After The Ring Study : DREAM’ (2017), (January), p. 2017. Available at:

Ariel, A. et al. (2003) ‘Aspirin-triggered lipoxin A4 and B4 analogs block extracellular signal-regulated kinase-dependent TNF-α secretion from human T cells’, The Journal of Immunology. Am Assoc Immnol, 170(12), pp. 6266–6272.

Auvert, B. et al. (2005) ‘Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial’, PLos med. Public Library of Science, 2(11), p. e298.

Baeten, J. M. et al. (2012) ‘Antiretroviral prophylaxis for HIV prevention in heterosexual men and women.’, New England Journal of Medicine, 367(5), p. 120711140017009. doi: 10.1056/NEJMoa1108524.

Baeten, J. M. et al. (2016) ‘Use of a Vaginal Ring Containing Dapivirine for HIV-1 Prevention in Women’, New England Journal of Medicine. Massachusetts Medical Society, 375(22), pp. 2121–2132. doi: 10.1056/NEJMoa1506110.

Bailey, R. C. et al. (2007) ‘Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial’, The lancet. Elsevier, 369(9562), pp. 643–656.

Barre-Sinoussi, F. et al. (1983) ‘Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS)’, Science, 220(4599), p. 868 LP-871. Available at:

Beignon, A.-S. et al. (2005) ‘Endocytosis of HIV-1 activates plasmacytoid dendritic cells via Toll-like receptor–viral RNA interactions’, The Journal of clinical investigation. Am Soc Clin Investig, 115(11), pp. 3265–3275.

Bevilacqua, A., Sinigaglia, M. and Corbo, M. R. (2008) ‘Alicyclobacillus acidoterrestris: New methods for inhibiting spore germination’, International Journal of Food Microbiology, 125(2), pp. 103–110. doi:

Bourne, N. et al. (1999) ‘The Topical Microbicide PRO 2000 Protects against Genital Herpes Infection in a Mouse Model’, The Journal of Infectious Diseases, 180(1), pp. 203–205. Available at:

Buchbinder, S. P. et al. (2008) ‘Efficacy assessment of a cell-mediated immunity HIV-1 vaccine (the Step Study): a double-blind, randomised, placebo-controlled, test-of-concept trial’, The Lancet, 372(9653), pp. 1881–1893. doi: 10.1016/S0140-6736(08)61591-3.

Card, C. M. et al. (2009) ‘Decreased immune activation in resistance to HIV-1 infection is associated with an elevated frequency of CD4(+)CD25(+)FOXP3(+) regulatory T cells.’, The Journal of infectious diseases, 199(9), pp. 1318–1322. doi: 10.1086/597801.

Card, C. M., Ball, T. B. and Fowke, K. R. (2013) ‘Immune quiescence: a model of protection against HIV infection’, Retrovirology, 10(1), p. 141. doi: 10.1186/1742-4690-10-141.

Cardo, D. M. et al. (1997) ‘A Case–Control Study of HIV Seroconversion in Health Care Workers after Percutaneous Exposure’, New England Journal of Medicine. Massachusetts Medical Society, 337(21), pp. 1485–1490. doi: 10.1056/NEJM199711203372101.

Chen, B. A. et al. (2015) ‘Phase 1 Safety, Pharmacokinetics, and Pharmacodynamics of Dapivirine and Maraviroc Vaginal Rings: a Double-Blind Randomized Trial’, Journal of acquired immune deficiency syndromes (1999), 70(3), pp. 242–249. doi: 10.1097/QAI.0000000000000702.

Choopanya, K. et al. (2013) ‘Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): A randomised, double-blind, placebo-controlled phase 3 trial’, The Lancet. Elsevier Ltd, 381(9883), pp. 2083–2090. doi: 10.1016/S0140-6736(13)61127-7.

Coe, L. M., Denison, J. D. and McCabe, L. R. (2011) ‘Low dose aspirin therapy decreases blood glucose levels but does not prevent type i diabetes-induced bone loss’, Cellular Physiology and Biochemistry. Karger Publishers, 28(5), pp. 923–932.

Cohen, C. R. et al. (2011) ‘Increased levels of immune activation in the genital tract of healthy young women from sub-Saharan Africa’, Aids, 24(13), pp. 2069–2074. doi: 10.1097/QAD.0b013e32833c323b.Increased.

Cohen, S. (2003) ‘The ABC Approach to HIV Prevention : A Policy Analysis A Selection of Articles on A , B and C from On Public Policy Beyond Slogans : Lessons From Uganda ’ s Experience With ABC and HIV / AIDS’, Public Policy, pp. 1–14.

Coll, J. et al. (2015) ‘Single oral dose of maraviroc does not prevent ex-vivo HIV infection of rectal mucosa in HIV-1 negative human volunteers’, AIDS, 29(16). Available at:

Connor, E. M. et al. (1994) ‘Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment’, New England Journal of Medicine. Mass Medical Soc, 331(18), pp. 1173–1180.

Corbett, E. L. et al. (2002) ‘HIV-1/AIDS and the control of other infectious diseases in Africa’, The Lancet. Elsevier, 359(9324), pp. 2177–2187.

Corey, L. et al. (2004) ‘The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics’, JAIDS Journal of Acquired Immune Deficiency Syndromes. LWW, 35(5), pp. 435–445.

Cu-Uvin, S. et al. (2000) ‘Effect of highly active antiretroviral therapy on cervicovaginal HIV-1 RNA’, Aids, 14(4), pp. 415–421. Available at:

van Damme, L. et al. (2008) ‘Lack of Effectiveness of Cellulose Sulfate Gel for the Prevention of Vaginal HIV Transmission’, New England Journal of Medicine. Massachusetts Medical Society, 359(5), pp. 463–472. doi: 10.1056/NEJMoa0707957.

van Damme, L. et al. (2012) ‘Preexposure prophylaxis for HIV infection among African women.’, The New England journal of medicine, 367(5), pp. 411–22. doi: 10.1056/NEJMoa1202614.

van Damme, L. et al. (2017) ‘Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial’, The Lancet. Elsevier, 360(9338), pp. 971–977. doi: 10.1016/S0140-6736(02)11079-8.

Duerr, A., Huang, Y., Buchbinder, S., Coombs, R. W., et al. (2012) ‘Extended follow-up confirms early vaccine-enhanced risk of HIV acquisition and demonstrates waning effect over time among participants in a randomized trial of recombinant adenovirus HIV vaccine (Step Study)’, Journal of Infectious Diseases, 206(2), pp. 258–266. doi: 10.1093/infdis/jis342.

El-Sadr, W. M. et al. (2006) ‘Safety and acceptability of cellulose sulfate as a vaginal microbicide in HIV-infected women’, Aids. LWW, 20(8), pp. 1109–1116.
Feldblum, P. J. et al. (2008) ‘SAVVY Vaginal Gel (C31G) for Prevention of HIV Infection: A Randomized Controlled Trial in Nigeria’, PLOS ONE. Public Library of Science, 3(1), p. e1474. Available at:

Fesen, M. R. et al. (1993) ‘Inhibitors of human immunodeficiency virus integrase.’, Proceedings of the National Academy of Sciences of the United States of America, 90(6), pp. 2399–2403.

Fichorova, R. N. (2004) ‘Interleukin (IL)-1, IL-6, and IL-8 Predict Mucosal Toxicity of Vaginal Microbicidal Contraceptives’, Biology of Reproduction, 71(3), pp. 761–769. doi: 10.1095/biolreprod.104.029603.

Fichorova, R. N., Tucker, L. D. and Anderson, D. J. (2001) ‘The molecular basis of nonoxynol-9-induced vaginal inflammation and its possible relevance to human immunodeficiency virus type 1 transmission’, Journal of Infectious Diseases. Oxford University Press, 184(4), pp. 418–428.

Fowke, K. R. et al. (1996) ‘Resistance to HIV-1 infection among persistently seronegative prostitutes in Nairobi, Kenya’, Lancet, 348. doi: 10.1016/S0140-6736(95)12269-2.

Ganesan, A. et al. (2011) ‘High dose atorvastatin decreases cellular markers of immune activation without affecting HIV-1 RNA levels: results of a double-blind randomized placebo controlled clinical trial.’, J Infect Dis., 203(6), pp. 756–64. doi: 10.1093/infdis/jiq115.

Giorgi, J. V et al. (1993) ‘Elevated Levels of CD38+ CD8+ T Cells in HIV Infection Add to the Prognostic Value of Low CD4+ T Cell Levels: Results of 6 Years of Follow-Up.’, JAIDS Journal of Acquired Immune Deficiency Syndromes, 6(8). Available at:

Giorgi, J. V et al. (1999) ‘Shorter Survival in Advanced Human Immunodeficiency Virus Type 1 Infection Is More Closely Associated with T Lymphocyte Activation than with Plasma Virus Burden or Virus Chemokine Coreceptor Usage’, The Journal of Infectious Diseases, 179(4), pp. 859–870. Available at:

Global Advocacy for HIV Prevention, A. (no date) HVTN 702. Available at:

Grant, R. M. et al. (2010) ‘Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men’, New England Journal of Medicine. Massachusetts Medical Society, 363(27), pp. 2587–2599. doi: 10.1056/NEJMoa1011205.

Gray, G. E. et al. (2011) ‘Safety and efficacy assessment of the HVTN 503/Phambili Study: A double-blind randomized placebo-controlled test-of-concept study of a Clade B-based HIV-1 vaccine in South Africa’, The Lancet infectious diseases, 11(7), pp. 507–515. doi: 10.1016/S1473-3099(11)70098-6.

Gray, R. H. et al. (2017) ‘Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial’, The Lancet. Elsevier, 369(9562), pp. 657–666. doi: 10.1016/S0140-6736(07)60313-4.

Group, rgp120 H. I. V. V. S. (2005) ‘Placebo-controlled phase 3 trial of a recombinant glycoprotein 120 vaccine to prevent HIV-1 infection’, Journal of Infectious Diseases. Oxford University Press, 191(5), pp. 654–665.

Guffey, M. B. et al. (2014) ‘HPTN 035 phase II/IIb randomised safety and effectiveness study of the vaginal microbicides BufferGel and 0.5% PRO 2000 for the prevention of sexually transmitted infections in women’, Sexually Transmitted Infections. Edited by R. S.-T. Black L Estep, S Profy, A Moench, T Karim, SA Taha, T Kumwenda, N Makanani, B Hurst, S Nkhoma, C Kachale, E Ramjee, G Govinden, R Coumi, N Dladla-Qwabe, N Ganesh, S Morar, N Chirenje, ZM Padian, N van der Straten, A Magure, T Mlingo, M Mgodi, N Hoffman,. Available at:

Gulick, R. M. et al. (1997) ‘Treatment with Indinavir, Zidovudine, and Lamivudine in Adults with Human Immunodeficiency Virus Infection and Prior Antiretroviral Therapy’, New England Journal of Medicine. Massachusetts Medical Society, 337(11), pp. 734–739. doi: 10.1056/NEJM199709113371102.

Gupta, P. et al. (1997) ‘High viral load in semen of human immunodeficiency virus type 1-infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors.’, Journal of virology, 71(8), pp. 6271–5. Available at:

Haase, A. T. et al. (2015) ‘Glycerol Monolaurate Microbicide Protection against Repeat High-Dose SIV Vaginal Challenge’, PLOS ONE. Public Library of Science, 10(6), p. e0129465. Available at:

Haire, B. G. (2015) ‘Preexposure prophylaxis-related stigma: Strategies to improve uptake and adherence ???a narrative review’, HIV/AIDS - Research and Palliative Care, 7, pp. 241–249. doi: 10.2147/HIV.S72419.
Halpern, V. et al. (2008) ‘Effectiveness of cellulose sulfate vaginal gel for the prevention of HIV infection: Results of a phase III trial in Nigeria’, PLoS ONE, 3(11), pp. 1–7.
doi: 10.1371/journal.pone.0003784.

Hammer, S. M. et al. (2013) ‘Efficacy trial of a DNA/rAd5 HIV-1 preventive vaccine.’, The New England Journal of Medicine, 369(22), pp. 2083–92. doi: 10.1056/NEJMoa1310566.

Hegde, B. M. (2006) ‘Coconut Oil–Ideal Fat next only to Mother’s Milk (Scanning Coconut’s Horoscope)’, Journal, Indian Academy of clinical medicine, 7(1), p. 17.

Henderson, D. K. and Gerberding, J. L. (1989) ‘Prophylactic Zidovudine after Occupational Exposure to the Human Immunodeficiency Virus: An Interim Analysis’, The Journal of Infectious Diseases, 160(2), pp. 321–327. Available at:
International Partnership for Microbicides (2016) ‘Two Large Studies Show IPM ’ s Monthly Vaginal Ring Helps Protect Women Against HIV’.

Jennes, W. et al. (2006) ‘Suppressed cellular alloimmune responses in HIV-exposed seronegative female sex workers.’, Clinical and experimental immunology, 143(3), pp. 435–44. doi: 10.1111/j.1365-2249.2006.03017.x.

Jiang, M.-C., Lin, J.-K. and Chen, S. S.-L. (1996) ‘Inhibition of HIV-1 Tat-mediated transactivation by quinacrine and chloroquine’, Biochemical and biophysical research communications. Elsevier, 226(1), pp. 1–7.

Johnson, L. F. and Lewis, D. A. (2008) ‘The effect of genital tract infections on HIV-1 shedding in the genital tract: a systematic review and meta-analysis’, Sexually transmitted diseases. LWW, 35(11), pp. 946–959.

Karasavvas, N. et al. (2012) ‘The Thai Phase III HIV Type 1 Vaccine trial (RV144) regimen induces antibodies that target conserved regions within the V2 loop of gp120’, AIDS research and human retroviruses. Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA, 28(11), pp. 1444–1457.

Karim, S. S. A. et al. (2011) ‘Safety and Effectiveness of BufferGel and 0.5% PRO2000 Gel for the Prevention of HIV Infection in Women’, AIDS (London, England), 25(7), pp. 957–966. doi: 10.1097/QAD.0b013e32834541d9.

Karres, I. et al. (1998) ‘Chloroquine inhibits proinflammatory cytokine release into human whole blood’, American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, 274(4), pp. R1058–R1064. Available at:

Kaul, R. et al. (1999) ‘HIV-1-specific mucosal IgA in a cohort of HIV-1-resistant Kenyan sex workers’, Aids. LWW, 13(1), pp. 23–29.

Kitahata, M. M. et al. (2009) ‘Effect of Early versus Deferred Antiretroviral Therapy for HIV on Survival’, New England Journal of Medicine. Massachusetts Medical Society, 360(18), pp. 1815–1826. doi: 10.1056/NEJMoa0807252.

Klatt, N. R. et al. (2017) ‘Vaginal bacteria modify HIV tenofovir microbicide efficacy in African women’, Science, 356(6341), p. 938 LP-945. Available at:

Koning, F. a et al. (2005) ‘Low-level CD4+ T cell activation is associated with low susceptibility to HIV-1 infection’, Journal of Immunology, 175(9), pp. 6117–6122. doi: 10.4049/jimmunol.175.9.6117.

Kreiss, J. et al. (1992) ‘Efficacy of nonoxynol 9 contraceptive sponge use in preventing heterosexual acquisition of hiv in nairobi prostitutes’, JAMA, 268(4), pp. 477–482. Available at:

Lajoie, J. et al. (2012) ‘A distinct cytokine and chemokine profile at the genital mucosa is associated with HIV-1 protection among HIV-exposed seronegative commercial sex workers’, Mucosal Immunology. Nature Publishing Group, 5(3), pp. 277–287. doi: 10.1038/mi.2012.7.

Li, Q. et al. (2009) ‘Glycerol monolaurate prevents mucosal SIV transmission’, Nature. Macmillan Publishers Limited. All rights reserved, 458(7241), pp. 1034–1038. Available at:

Lieberman, S., Enig, M. G. and Preuss, H. G. (2006) ‘A review of monolaurin and lauric acid: natural virucidal and bactericidal agents’, Alternative & Complementary Therapies. Mary Ann Liebert, Inc. 2 Madison Avenue Larchmont, NY 10538 USA, 12(6), pp. 310–314.

Liu, Z. et al. (1998) ‘CD8+ T-Lymphocyte Activation in HIV-1 Disease Reflects an Aspect of Pathogenesis Distinct From Viral Burden and Immunodeficiency.’, JAIDS Journal of Acquired Immune Deficiency Syndromes, 18(4). Available at:

Lozenski, K. et al. (2012) ‘Decreased cervical epithelial sensitivity to nonoxynol-9 (N-9) after four daily applications in a murine model of topical vaginal microbicide safety’, BMC Pharmacology and Toxicology. BioMed Central, 13(1), p. 9.

Mack, N. et al. (2014) ‘Barriers and facilitators to pre-exposure prophylaxis (PrEP) eligibility screening and ongoing HIV testing among target populations in Bondo and Rarieda, Kenya: Results of a consultation with community stakeholders’, BMC Health Services Research, 14, pp. 1–12. doi: 10.1186/1472-6963-14-231.

MacKelprang, R. D. et al. (2012) ‘Quantifying ongoing HIV-1 exposure in HIV-1-serodiscordant couples to identify individuals with potential host resistance to HIV-1’, Journal of Infectious Diseases, 206(8), pp. 1299–1308. doi: 10.1093/infdis/jis480.

Marais, D. et al. (2011) ‘The effectiveness of Carraguard, a vaginal microbicide, in protecting women against high-risk human papillomavirus infection’, Antiviral therapy, 16(8), p. 1219.

Marrazzo, J. M. et al. (2015) ‘Tenofovir-Based Preexposure Prophylaxis for HIV Infection among African Women’, New England Journal of Medicine. Massachusetts Medical Society, 372(6), pp. 509–518. doi: 10.1056/NEJMoa1402269.

Martinson, J. a. et al. (2010) ‘Chloroquine modulates HIV-1-induced plasmacytoid dendritic cell alpha interferon: Implication for T-cell activation’, Antimicrobial Agents and Chemotherapy, 54(2), pp. 871–881. doi: 10.1128/AAC.01246-09.

Mascolini, M. (2013) ‘HIV prevention fails in all three VOICE arms, as daily Truvada PrEP falls’, in 20th conference on retroviruses and opportunistic infections, pp. 33–36.

Masson, L. et al. (2014) ‘Defining genital tract cytokine signatures of sexually transmitted infections and bacterial vaginosis in women at high risk of HIV infection: a cross-sectional study’, Sexually transmitted infections. BMJ Publishing Group Ltd, 90(8), pp. 580–587.

Masson, L. et al. (2015) ‘Genital Inflammation and the Risk of HIV Acquisition in Women’, Clinical Infectious Diseases, 61(2), pp. 260–269. doi: 10.1093/cid/civ298.

Massud, I. et al. (2013) ‘Lack of prophylactic efficacy of oral maraviroc in macaques despite high drug concentrations in rectal tissues.’, Journal of virology, 87(16), pp. 8952–61. doi: 10.1128/JVI.01204-13.

McCoombe, S. G. and Short, R. V (2006) ‘Potential HIV-1 target cells in the human penis’, AIDS, 20(11). Available at:

McCormack, S. et al. (2010) ‘PRO2000 vaginal gel for prevention of HIV-1 infection (Microbicides Development Programme 301): A phase 3, randomised, double-blind, parallel-group trial’, The Lancet. Elsevier Ltd, 376(9749), pp. 1329–1337. doi: 10.1016/S0140-6736(10)61086-0.

McCormack, S. et al. (2017) ‘Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial’, The Lancet. Elsevier, 387(10013), pp. 53–60. doi: 10.1016/S0140-6736(15)00056-2.

McKinnon, L. R. et al. (2015) ‘Risk Factors for HIV Acquisition in a Prospective Nairobi-Based Female Sex Worker Cohort’, AIDS and Behavior. Springer US, 19(12), pp. 2204–2213. doi: 10.1007/s10461-015-1118-7.

McLaren, P. J. et al. (2010) ‘HIV‐exposed seronegative commercial sex workers show a quiescent phenotype in the CD4+ T cell compartment and reduced expression of HIV‐dependent host factors.’, The Journal of infectious diseases, 202 Suppl(Suppl 3), pp. S339-44. doi: 10.1086/655968.

Mesquita, P. M. M. et al. (2009) ‘Disruption of Tight Junctions by Cellulose Sulfate Facilitates HIV Infection: Model of Microbicide Safety’, The Journal of Infectious Diseases, 200(4), pp. 599–608. Available at:

Mitchell, C. M. et al. (2008) ‘Bacterial vaginosis, not HIV, is primarily responsible for increased vaginal concentrations of proinflammatory cytokines’, AIDS research and human retroviruses. Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801-5215 USA, 24(5), pp. 667–671.

Montaner, J. S. G. et al. (2011) ‘NIH Public Access’, 376(9740), pp. 532–539. doi: 10.1016/S0140-6736(10)60936-1.Expanded.

Montefiori, D. C. et al. (2012) ‘Magnitude and breadth of the neutralizing antibody response in the RV144 and Vax003 HIV-1 vaccine efficacy trials’, Journal of Infectious Diseases. Oxford University Press, 206(3), pp. 431–441.

Murphy, E. M. et al. (2006) ‘Was the “ABC” Approach (Abstinence, Being Faithful, Using Condoms) Responsible for Uganda’s Decline in HIV?’, PLOS Medicine. Public Library of Science, 3(9), p. e379. Available at:

Mutua, G. et al. (2012) ‘Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers.’, PloS one, 7(4), p. e33103. doi: 10.1371/journal.pone.0033103.

Naranbhai, V. et al. (2012) ‘Innate immune activation enhances HIV acquisition in women, diminishing the effectiveness of tenofovir microbicide gel’, Journal of Infectious Diseases, 206(7), pp. 993–1001. doi: 10.1093/infdis/jis465.

Pearce-Pratt, R. and Phillips, D. M. (1996) ‘Sulfated polysaccharides inhibit lymphocyte-to-epithelial transmission of human immunodeficiency virus-1.’, Biology of reproduction. Soc Study Reprod, 54(1), pp. 173–182.

Peterson, L. et al. (2007) ‘SAVVY® (C31G) Gel for Prevention of HIV infection in Women: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Ghana’, PLOS ONE. Public Library of Science, 2(12), p. e1312. Available at:

Peterson, M. L. and Schlievert, P. M. (2006) ‘Glycerol monolaurate inhibits the effects of Gram-positive select agents on eukaryotic cells’, Biochemistry. ACS Publications, 45(7), pp. 2387–2397.

Pettersen, F. O. et al. (2011) ‘An exploratory trial of cyclooxygenase type 2 inhibitor in HIV-1 infection: downregulated immune activation and improved T cell-dependent vaccine responses.’, Journal of virology, 85(13), pp. 6557–66. doi: 10.1128/JVI.00073-11.

Piconi, S. et al. (2011) ‘Hydroxychloroquine drastically reduces immune activation in HIV-infected, antiretroviral therapy-treated immunologic nonresponders’, Blood, 118(12), pp. 3263–3272. doi: 10.1182/blood-2011-01-329060.

Pitisuttithum, P. et al. (2006) ‘Randomized, double‐blind, placebo‐controlled efficacy trial of a bivalent recombinant glycoprotein 120 HIV‐1 vaccine among injection drug users in Bangkok, Thailand’, Journal of Infectious Diseases. Oxford University Press, 194(12), pp. 1661–1671.

Planagumà, A. et al. (2002) ‘Aspirin (ASA) regulates 5-lipoxygenase activity and peroxisome proliferator-activated receptor α-mediated CINC-1 release in rat liver cells: novel actions of lipoxin A4 (LXA4) and ASA-triggered 15-epi-LXA4’, The FASEB journal. FASEB, 16(14), pp. 1937–1939.

Rebbapragada, A. et al. (2007) ‘Negative mucosal synergy between Herpes simplex type 2 and HIV in the female genital tract’, Aids. LWW, 21(5), pp. 589–598.

Rees Helen, Delany-Moretlwe Sinead A., Lombard Carl, Baron Deborah, Panchia Ravindre, Myer Landon, Schwartz Jill L., Doncel Gustavo F., and G. G. (2015) FACTS 001 Phase III Trial of Pericoital Tenofovir 1% Gel for HIV Prevention in Women. Available at:

Rerks-Ngarm, S. et al. (2009) ‘Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand’, New England Journal of Medicine. Mass Medical Soc, 361(23), pp. 2209–2220.

Richardson, B. a et al. (2001) ‘Evaluation of a low-dose nonoxynol-9 gel for the prevention of sexually transmitted diseases: a randomized clinical trial.’, Sexually Transmitted Diseases, 28(7), pp. 394–400. Available at:

Roddy, R. E. et al. (1998) ‘A Controlled Trial of Nonoxynol 9 Film to Reduce Male-to-Female Transmission of Sexually Transmitted Diseases’, New England Journal of Medicine. Massachusetts Medical Society, 339(8), pp. 504–510. doi: 10.1056/NEJM199808203390803.

Rodger, A. J. et al. (2016) ‘Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy.’, Jama, 316(2), pp. 171–81. doi: 10.1001/jama.2016.5148.

Rusconi, S. et al. (1996) ‘Naphthalene sulfonate polymers with CD4-blocking and anti-human immunodeficiency virus type 1 activities.’, Antimicrobial agents and chemotherapy. Am Soc Microbiol, 40(1), pp. 234–236.

Ruzin, A. and Novick, R. P. (2000) ‘Equivalence of Lauric Acid and Glycerol Monolaurate as Inhibitors of Signal Transduction in Staphylococcus aureus’, Journal of Bacteriology. American Society for Microbiology, 182(9), pp. 2668–2671. Available at:

SÁNCHEZ, J. et al. (2003) ‘Prevention of Sexually Transmitted Diseases (STDs) in Female Sex Workers: Prospective Evaluation of Condom Promotion and Strengthened STD Services’, Sexually Transmitted Diseases, 30(4). Available at:

Savarino, a et al. (2001) ‘Anti-HIV effects of chloroquine: mechanisms of inhibition and spectrum of activity.’, AIDS (London, England), 15(17), pp. 2221–2229. doi: 10.1097/00002030-200111230-00002.

Schlievert, P. M. et al. (2008) ‘Glycerol monolaurate does not alter rhesus macaque (Macaca mulatta) vaginal lactobacilli and is safe for chronic use’, Antimicrobial agents and chemotherapy. Am Soc Microbiol, 52(12), pp. 4448–4454.

Siegfried, N. et al. (2011) ‘Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection’, … Database Syst Rev, (7). doi: 10.1002/14651858.CD003510.pub3.Copyright.

Skoler-Karpoff, S. et al. (2008) ‘Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trial’, The Lancet, 372(9654), pp. 1977–1987. doi:

Smith, D. K. et al. (2015) ‘Condom Effectiveness for HIV Prevention by Consistency of Use Among Men Who Have Sex With Men in the United States’, JAIDS Journal of Acquired Immune Deficiency Syndromes, 68(3). Available at:

Songok, E. M. et al. (2012) ‘Microarray analysis of HIV resistant female sex workers reveal a gene expression signature pattern reminiscent of a lowered immune activation state’, PLoS ONE, 7(1). doi: 10.1371/journal.pone.0030048.

de Souza, M. S. et al. (2012) ‘The Thai phase III trial (RV144) vaccine regimen induces T cell responses that preferentially target epitopes within the V2 region of HIV-1 envelope.’, Journal of immunology (Baltimore, Md. : 1950), 188(10), pp. 5166–76. doi: 10.4049/jimmunol.1102756.

Spencer, S. E. et al. (2004) ‘Inhibition of Neisseria gonorrhoeae Genital Tract Infection by Leading-Candidate Topical Microbicides in a Mouse Model’, The Journal of Infectious Diseases, 189(3), pp. 410–419. Available at:

Van Der Straten, A. et al. (2014) ‘Perspectives on use of oral and vaginal antiretrovirals for HIV prevention: The VOICE-C qualitative study in Johannesburg, South Africa’, Journal of the International AIDS Society, 17(3), pp. 1–7. doi: 10.7448/IAS.17.3.19146.

Sturm-Ramirez, K. et al. (2000) ‘High Levels of Tumor Necrosis Factor—α and Interleukin-1β in Bacterial Vaginosis May Increase Susceptibility to Human Immunodeficiency Virus’, Journal of Infectious Diseases. Oxford University Press, 182(2), pp. 467–473.

SUDOL, K. M. and PHILLIPS, D. M. (2004) ‘Relative Safety of Sexual Lubricants for Rectal Intercourse’, Sexually Transmitted Diseases, 31(6). Available at:

Townsend, C. L. et al. (2008) ‘Low rates of mother-to-child transmission of HIV following effective pregnancy interventions in the United Kingdom and Ireland, 2000-2006.’, AIDS (London, England), 22(8), pp. 973–81. doi: 10.1097/QAD.0b013e3282f9b67a.

Unaids (2016) ‘Fact Sheet 2016’, 2030 | E n d i n g t h e A I D S e p i d e m i c, pp. 1–8. Available at:

UNAIDS (2010) ‘Combination HIV Prevention: Tailoring and Coordinating Biomedical, Behavioural and Structural Strategies to Reduce New HIV Infections’, A UNAIDS Discussion Paper.

Veazey, R. S. et al. (2010) ‘Protection of Rhesus Macaques from Vaginal Infection by Vaginally Delivered Maraviroc, an Inhibitor of HIV-1 Entry via the CCR5 Co-Receptor’, The Journal of Infectious Diseases, 202(5), pp. 739–744. Available at:

Weijma, R. G. M. et al. (2016) ‘The Effect of Rosuvastatin on Markers of Immune Activation in Treatment-Naive Human Immunodeficiency Virus-Patients.’, Open forum infectious diseases, 3(1), p. ofv201. doi: 10.1093/ofid/ofv201.

Williams, B. and Gouws, E. (2012) ‘Pre-exposure prophylaxis (PrEP) versus treatment-as-prevention (TasP) for the control of HIV: Where does the balance lie?’, arXiv preprint arXiv: …, pp. 1–4. Available at:

World Health Organization (2015) ‘Guidelines Guideline on When To Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for Hiv’, (September), p. 78. doi: 978 92 4 150956 5.

World Health Organisation (WHO) (2012) ‘Programmatic Update Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing Hiv Infection in Infants Executive Summary’, Who, 45(April), p. 5. doi: 10.1162/LEON_r_00464.

World Health Organisation (WHO) (2015) ‘PRE-EXPOSURE PROPHYLAXIS ( PrEP ) WHO EXPANDS RECOMMENDATION ON ORAL PRE- EXPOSURE PROPHYLAXIS OF HIV INFECTION ( PrEP ) What does WHO Key evidence # OfferPrEP Will PrEP be cost- Considerations for PrEP’, (November). Available at:

World Health Organization (WHO) (2007) WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention. Available at:

World Health Organization (WHO) (2012) Voluntary medical male circumcision for HIV prevention, Fact sheet: July 2012. Available at:

Wyrick, P. B. et al. (1997) ‘The microbicidal agent C31G inhibits Chlamydia trachomatis infectivity in vitro’, Antimicrobial Agents and Chemotherapy, 41(6), pp. 1335–1344.

Zacharopoulos, V. R. and Phillips, D. M. (1997) ‘Vaginal formulations of carrageenan protect mice from herpes simplex virus infection.’, Clinical and diagnostic laboratory immunology. Am Soc Microbiol, 4(4), pp. 465–468.

Zolla-Pazner, S. et al. (2013) ‘Analysis of V2 Antibody Responses Induced in Vaccinees in the ALVAC/AIDSVAX HIV-1 Vaccine Efficacy Trial’, PLoS ONE, 8(1), pp. 1–11. doi: 10.1371/journal.pone.0053629.

Zuckerman, R. a et al. (2004) ‘Higher concentration of HIV RNA in rectal mucosa secretions than in blood and seminal plasma, among men who have sex with men, independent of antiretroviral therapy’, The Journal of Infectious Diseases, 190(1), pp. 156–161. doi: 10.1086/421246.

Zuckerman, R. a et al. (2007) ‘Herpes Simplex Virus ( HSV ) Suppression with Valacyclovir Reduces Rectal and Blood Plasma HIV-1 Levels in HIV-1 / HSV-2 – Seropositive Men : A Randomized , Double-Blind , Placebo-Controlled Crossover Trial’, 196. doi: 10.1086/522523.



How to Cite

Mwangi, L. W., Lajoie, J., Oyugi, J. O., & Fowke, K. R. (2019). Combating HIV/AIDS: Biomedical Approaches Towards Prevention: Biomedical Approaches Towards Prevention. African Journal of Biomedical Research, 22(2), 105 - 114. Retrieved from



Review Article

Most read articles by the same author(s)