Pre-exposure prophylaxis for HIV: effective and underused
Abstract
Pre-exposure prophylaxis (PrEP) is a highly effective modality for HIV prevention that can be prescribed by generalists.
Pre-exposure prophylaxis should be offered to patients who are at high risk of HIV exposure, including gay, bisexual and other men who have sex with men (GBM), women reporting condomless intercourse with partners of confirmed or unknown transmissible HIV status and persons who inject drugs and share injection equipment.
Once daily PrEP (tenofovir disoproxil fumarate/emtricitabine [TDF/FTC] or tenofovir alafenamide fumarate/emtricitabine tablets) is approved by Health Canada.
On-demand TDF/FTC can be prescribed to gay, bisexual and other men who have sex with men and has similar efficacy.
The Canadian guideline details protocolized monitoring for PrEP follow-up including HIV screening, screening for sexually transmitted infection and renal monitoring.
RPR Commentary
Pre-exposure prophylaxis should be offered to those at high risk for HIV. James W. Mold, MD, MPH