From the Guidelines
Pre-exposure prophylaxis (PrEP) is recommended for individuals at high risk of HIV infection, including men who have sex with men (MSM), transgender women, heterosexually active men and women at substantial risk of HIV infection, persons who inject drugs (PWID), and heterosexually-active HIV-serodiscordant couples. The most common PrEP regimen is daily oral Truvada (emtricitabine 200mg/tenofovir disoproxil fumarate 300mg) or Descovy (emtricitabine 200mg/tenofovir alafenamide 25mg) 1.
Key Points to Consider
- PrEP should be considered for HIV-negative individuals who have condomless sex with partners of unknown HIV status, multiple sexual partners, inconsistent condom use, commercial sex workers, injection drug users sharing equipment, or those in serodiscordant relationships (where one partner has HIV) 1.
- Before starting PrEP, patients need HIV testing, kidney function assessment, hepatitis B screening, and STI testing 1.
- PrEP takes about 7 days to reach protective levels for rectal exposure and 21 days for vaginal exposure 1.
- Regular follow-up every 3 months is necessary for HIV testing, medication adherence assessment, and side effect monitoring 1.
- PrEP works by preventing HIV from establishing infection in the body when exposed, blocking the virus's ability to replicate 1.
Important Considerations
- It's highly effective when taken consistently but doesn't protect against other STIs, so condom use is still recommended.
- The use of PrEP should be based on individual risk assessment and should be part of a comprehensive HIV prevention strategy.
- Healthcare providers should be aware of the latest guidelines and recommendations for PrEP use, including the most recent study published in 2020 1.
From the Research
Conditions that use Prepackaged (Prep) Medications
- HIV infection prevention: Preexposure prophylaxis (PrEP) is used to prevent HIV infection in individuals at high risk of acquisition, including those with multiple sexual partners, men who have sex with men, and individuals who share needles or other equipment to inject drugs 2, 3, 4, 5, 6
- High-risk populations: PrEP is recommended for individuals at high risk of HIV acquisition, including sexually active adolescents and adults, men who have sex with men, and individuals who engage in high-risk behaviors such as injection drug use or unprotected sex 2, 3, 4, 5
- Specific risk groups: PrEP is particularly recommended for individuals who engage in condomless receptive anal intercourse, those who have multiple sexual partners, and those who have a history of sexually transmitted infections 4, 5
Types of PrEP Regimens
- Oral formulations: PrEP can be taken orally, with regimens including emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide, and others 4, 5, 6
- Injectable formulations: PrEP can also be administered via injection, with regimens including cabotegravir and others 4, 6
- Long-acting agents: Second-generation PrEP agents, such as monthly vaginal rings and PrEP injectables, are being developed to overcome challenges with daily adherence and persistence 6