Multiple choice questions: ANSWERS Chapter 1. Diagnosis and promotion of serostatus awareness in sub-saharan Africa 1. Antiretroviral therapy reduces HIV transmission from a HIV- positive person to a susceptible partner by: a. >90% 2. Coverage of annual HIV testing in sub-saharan Africa is approximately: a. 20 30% 3. Project Accept demonstrated that community mobilization followed by mobile voluntary counseling and testing has the potential to increase HIV testing among: a. Men and young people, in addition to women 4. A systematic review of home-based HIV counseling and testing found the proportion of clients who received their HIV test results was: a. 77% 5. Studies of couples-based counseling and testing have found that it is associated with: Chapter 3. The ART of pre- and post-exposure prophylaxis 1. Pre-exposure prophylaxis (PrEP) could be a useful risk reduction intervention for the following patients: e. All of the above 2. The following antiretrovirals have been studied for use as PrEP and been registered by the US FDA: a. Tenofovir plus emtricitabine combination For reprint orders, please contact: reprints@futuremedicine.com www.futuremedicine.com 139
3. Which of the following was the most important factor affecting the efficacy of Truvada -based PrEP? c. The ability to adhere and take Truvada as prescribed 4. The evidence base for postexposure prophylaxis (PEP) is based on the following: c. Animal studies and case reports 5. In which of the following scenarios would PEP be appropriate: c. All of the above Chapter 4. Microbicides for HIV prevention: theory and future prospects 1. The risk of HIV acquisition in the rectal mucosa versus the vaginal mucosa is? c. Up to 20-times higher in rectal mucosa than vaginal mucosa 2. The risk of HIV transmission is affected by: c. a and c 3. Which attribute is not critical for rectal microbicide safety? c. Color of microbicide 4. Which of the following statements is/are not true? c. Several microbicides have been tested, yet there is no proof that microbicides can prevent HIV in humans 5. A BAT24 dosing regimen is: c. One dose of microbicide before sex and one dose after sex but no more than 2 in 24 h 6. Which of the following is/are not an antiretroviral microbicide? c. Carraguard 7. Which of the following microbicide formulation is/are not being developed? c. Vapor Chapter 5. HIV prevention and men: general population and vulnerable subgroups 1. What approaches to HIV prevention are likely to increase coverage and involvement of men in the prevention programmes? f. c and d 140 www.futuremedicine.com
2. What are the main benefits of voluntary male medical circumcision? e. a and c 3. Why is it important to focus on HIV prevention for men who have sex with men (MSM) in South Africa? d. b and c 4. Clinical and biomedical interventions for MSM can only be delivered in specialist services which makes them costly and impractical in the context of generalised HIV epidemics such South Africa. b. False 5. Effective behavioural and structural interventions that benefit men have significant spin-off prevention benefits for women. a. True Chapter 6. Implementation of HIV treatment-as-prevention: resources and behaviors 1. To date, 10 million people have started antiretroviral treatment worldwide. This success is remarkable because: c. This is an important fraction of those in need, preventing some transmissions e. This paves the path to the treatment-as-prevention target, i.e., three-times more patients to treat in several countries 2. Treatment-as-prevention implies that antiretroviral treatment is used universally and as soon as possible in the course of HIV infection. This statement is: d. A concept developed by statistical modelers and requires field research e. A community intervention that extends on findings on HPTN052 study conducted in serodiscordant couples 3. Implementing treatment-as-prevention has financial implications: d. Both substantial extra funding and better use of available resources are necessary 4. Healthcare workers are necessary to implement treatment-asprevention: d. The manpower issue requires distinct short-term and long-term solutions www.futuremedicine.com 141
5. The relationship between treatment-as-prevention and behavior has several dimensions: e. Monitoring adherence, retention and sexual behavior is needed as treatment-as-prevention is introduced Chapter 7. Prevention of sexual transmission of HIV in adolescents 1. In what region do young people face the highest burden from HIV? b. Sub-Saharan Africa 2. Adolescents may be at heightened risk for HIV due to: 3. Which of the following is not an example of a structural intervention? b. Antiretroviral therapy 4. Which of the following is an example of a challenge in HIV prevention specific to adolescents? 5. Which type of interventions hold the greatest promise for reducing new HIV infections in adolescents? d. Multicomponent interventions Chapter 8. Mathematical modeling of HIV elimination strategies 1. Which of the following statements is not true? d. Population-based models simulate unique individuals 2. Next to determining whether elimination is possible, R 0 can also give information on: c. The required vaccination coverage in order to eliminate the disease 3. An elimination threshold : d. Is a low-level incidence below which the disease enters the elimination phase 4. Stochastically generated elimination probabilities: a. Are sensitive to the modelled population size 142 www.futuremedicine.com
5. Which of the following statements is not true? b. The costs of treating opportunistic infections such as TB should not be included in economic evaluations 6. Uncertainty analyses d. Reflect the uncertainty in the parameter estimates of the model www.futuremedicine.com 143