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Updated: May 23, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
HIV and chemoprophylaxis, the importance of considering social structures alongside biomedical and behavioral
Eric T Roberts1, Derrick D Matthews
1Columbia University, Department of Epidemiology, Mailman School of Public Health, 710 W 168th Street, NI 614-A, New York, NY 10032, United States. etr2113@columbia.edu
Abstract:
This manuscript draws connections between chemoprophylaxis and the biomedical model of disease that emphasizes individual behavior. We argue that chemoprophylactic HIV interventions have limited utility at the population-level, and that structural interventions need to be prioritized. We use the recent CAPRISA 004 and iPrEx trials to (a) critique the utility of these trials from a public health perspective by highlighting the difference between efficacy and effectiveness, (b) apply an alternative theory of health behavior as a way to reorient the field toward the discussion of the need to employ structural interventions, and (c) examine two aspects of HIV prevention efforts - funding structures and iatrogenic effects of biomedical approaches - as a means of overcoming obstacles to more widespread adoption of structural interventions.
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