Pre-exposure prophylaxis (PrEP) in an era of stalled HIV prevention: Can it change the game?

Pre-exposure prophylaxis (PrEP) for HIV prevention has evolved significantly over the years where clinical trials have now demonstrated the efficacy of oral PrEP, and the field is scaling-up implementation. The WHO and UNAIDS have made PrEP implementation a priority for populations at highest risk, and several countries have developed guidelines and national plans accordingly, largely based on evidence generated by demonstration projects. PrEP presents the opportunity to change the face of HIV prevention by offering a new option for protection against HIV and disrupting current HIV prevention systems. Nevertheless, as with all new technologies, both practical and social requirements for implementation must be taken into account if there is to be sustained and widespread adoption, which will also apply to forthcoming prevention technologies. Defining and building success for PrEP within the scope of scale-up requires careful consideration. This review summarises where the PrEP field is today, lessons learned from the past, the philosophy and practicalities of how successful programming may be defined, and provides perspectives of costs and affordability. We argue that a successful PrEP programme is about effective intervention integration and ultimately keeping people HIV negative

Editorial

Professor Dana van der Merwe of the University of South Africa (UNISA) delves into the impact of the information era on the law, drawing distinctions with the aid of legal philosophy between data, information and intelligence. o    In similar vein Dr Tanya du Plessis of the University of Johannesburg investigates the impact of information and communication technology on the practice of law and knowledge management in law firms. o    Professor Anneliese Roos of UNISA follows with an in-depth and comparative exposition of statutory data protection with specific reference to the legislation of New Zealand, illustrating important disadvantages for participants in the information technology arena in South Africa

Editorial

In this first of at least three editions planned for 2006, the focus is on environmental law:  Professor Verschuuren of Tilburg University attributes the high moral value of the principles of environmental law to the ideal of sustainable development.    Advocate Paschke and Professor Glazewski of Cape Town offers strong arguments against allowing retrospective environmental authorisation as militating against the purposes of environmental assessment.    &nbsp

Editorial

 This issue deals with a selection of topics of environmental law. As it should be clear from the short tribute written by Margaret Beukes, the issue is devoted to Professor Elmien Bray, for many years a force in the emergence of South African environmental law. Jonathan Verschuuren of Tilburg University expertly comments on the Dutch Crisis and Recovery Act, showing clearly why it is such a controversial piece of legislation: balancing economic recovery with sustainable development, sound principles of law, justice and crisis management is shown to be a very hard result to achieve by means of legislation.  &nbsp

Treatment And Prevention for female Sex workers in South Africa: protocol for the TAPS Demonstration Project.

INTRODUCTION: Updated guidelines from the WHO recommend antiretroviral treatment for adults with HIV at any CD4 count and daily oral pre-exposure prophylaxis (PrEP) for people at substantial risk of HIV infection. However, implementation challenges may hinder the ability of programmes to translate these recommendations into successful practice. This demonstration project is the first to integrate PrEP and immediate treatment (ITx) for female sex workers (FSWs) in South Africa to answer operational research questions. METHODS AND ANALYSIS: This is a prospective cohort study where the main outcome is retention at 12 months. The study population is recruited into two arms across two urban sites: (1) PrEP for HIV-negative FSWs (n=400) and (2) ITx for HIV-positive FSWs with CD4 greater than national guidelines (n=300). We investigate process and other health indicators, uptake and use of PrEP and ITx through qualitative research, and evaluate cost-effectiveness analysis combined with estimates of impact through epidemiological modelling. ETHICS AND DISSEMINATION: The Treatment And Prevention for female Sex workers in South Africa (TAPS) Project was designed as an implementation study before emtricitabine/tenofovir disoproxil fumarate was licenced as an indication for PrEP in South Africa. Therefore, clinical trial requirements for ethical and South African Medicines Control Council approvals were followed. Results will be disseminated to participants, local health officials and other stakeholders, as well as in peer-reviewed journals and at conferences

Editorial

This edition contains an interesting mixture of contributions from various parts of the world and from the perspective of various disciplines of the law.o Dr. Timothy I Akomolede of the Olabisi Onabanjo University in Nigeria highlights a number of legal and socio-economic problems that have been engendered by the emergence of electronic commerce, especially in developing countries such as Nigeria.  &nbsp

Editorial

In this issue the nexus between labour relations and electronic privacy, affirmative action in India, intercountry adoption of children, the award of costs in public interest litigation and the legal uncertainties surrounding liability for injuries of student actors are the themes of the contributions.    &nbsp

Regte, gesag en waardes

Rights, authority and valuesIn view of Johan van der Vyver's immense contribution to the clarification of the meaning of legal concepts, the establishment of terminology, the analysis of doctrines and the explanation of the foundations of matters, it is considered appropriate in this article to revisit a question which has occupied jurists since time immemorial, namely what a right might be. This question cannot be addressed without dealing with the context in which it stands. Therefore the fa te of the doctrine of subjective rights is firstly traced, after which the phenomena of human rights and fundamental rights are discussed Following these analyses, the question whether a single, comprehensive concept of right is viable is considered. In this context the need for the legal scholar to thoroughly consider the origin or justification for the existence of government authority is motivated. It seems as though unanimity about a concept o f right at anything beyond a relatively superficial, mechanical level is not really possible, but that a meaningful scholarly discourse on the matter is possible, at least among scholars who acknowledge the determining role of unverifiable presuppositions in the practice of scholarship. Finally it is argued that there is a connection between the values of the Constitution, the exercise of government authority and the development of a South African concept of right

Editorial

This first issue of 2007 covers a refreshing spectrum of legal disciplines ranging from cultural and linguistic issues, to the onus of proof in delict, the censorship debate and research methodology. Professor Elmene Bray of the University of South Africa analyses the complexities of the recent judgment of the Supreme Court of Appeal in a case involving the sensitive issue of the medium of instruction in public schools in South Africa.    &nbsp