Pre-exposure prophylaxis for HIV prevention

Pre-exposure prophylaxis (PrEP) is a medical approach used for the prevention of HIV infection in individuals who are at high risk but currently HIV-negative. PrEP involves taking a specific combination of HIV medications daily or around the time of potential HIV exposure to reduce the risk of acquiring HIV. This article provides an overview of PrEP, including its effectiveness, usage guidelines, and considerations.

Overview

Pre-exposure prophylaxis is a preventive strategy recommended by health organizations worldwide, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). It is considered a key component in the fight against the HIV/AIDS epidemic. PrEP is most commonly prescribed as a daily pill containing two antiretroviral medications, tenofovir disoproxil fumarate and emtricitabine (marketed under the brand name Truvada, among others). In some regions, a combination of tenofovir alafenamide and emtricitabine is also available.

Effectiveness

Studies have shown that when taken consistently, PrEP reduces the risk of acquiring HIV from sex by about 99% and from injection drug use by at least 74%. The effectiveness of PrEP is highly dependent on adherence to the medication regimen.

Eligibility

PrEP is recommended for individuals who are at substantial risk of HIV infection. This includes people who have an HIV-positive sexual partner, have inconsistent condom use with partners of unknown HIV status, share injection drug equipment, or have been diagnosed with a sexually transmitted infection (STI) in the past six months.

Usage Guidelines

Before starting PrEP, individuals must undergo an HIV test to confirm they are HIV-negative. Regular follow-ups every three months for HIV testing, kidney function tests, and counseling on adherence and risk reduction are also recommended.

Considerations

While PrEP is a powerful tool for preventing HIV, it does not protect against other STIs or unwanted pregnancy. The use of condoms is still recommended for broader sexual health protection. Side effects of PrEP are generally mild and may include nausea, headache, and weight loss, but these usually subside over time.

Access and Cost

Access to PrEP varies globally, with some countries offering it as part of public health programs, while in others, it may be costly or not widely available. Efforts are ongoing to increase PrEP accessibility and affordability worldwide.

Conclusion

Pre-exposure prophylaxis represents a significant advancement in HIV prevention efforts. When used as part of a comprehensive prevention strategy, PrEP offers an effective means of reducing the transmission of HIV and helping to curb the global HIV/AIDS epidemic.