Health Benefits of PrEP for HIV Prevention

PrEP, which stands for pre-exposure prophylaxis, is a medication regimen designed to reduce the chances of infection by the Human Immunodeficiency Virus (HIV) in at-risk patients. The most widely used PrEP medication is a combination of tenofovir disproxil fumarate (TDF) and emtricitabine. While generic versions of PrEP for HIV exist, in the United States, it is sold as "Truvada" by the pharmaceutical company Gilead Science.

When used consistently with appropriate precautions and regular visits to a physician to test for HIV PrEP can keep patients HIV-free for the duration of their lives.

Pre-exposure prophylaxis (PrEP) prevents HIV infection. Robust evidence—first from pivotal clinical trials, then rigorous studies testing best-practice models of implementation, and most recently real-world case studies of clinical delivery demonstrate that PrEP is highly effective, indeed incredibly so, at providing individual protection against HIV acquisition for men and women from diverse populations worldwide. Regulatory review and normative guidance from the US Food and Drug Administration in 2012 and from the US Centres for Disease Control and Prevention (CDC) in 2014 have been followed by World Health Organization recommendations in 2015, and thereafter by endorsements by more than two dozen countries. PrEP is thus a central part of global, evidence-based, gold-standard HIV prevention for at-risk individuals.

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Nevertheless, for PrEP to have an important impact on the HIV epidemic, it needs to have not just benefits for individuals but at the population level, synergizing with other prevention and treatment interventions to achieve substantive reductions in new infections and resultant morbidity and mortality from HIV. By 2020, the US National HIV/AIDS Strategy calls for a 25% reduction in new diagnoses, and UNAIDS has set a global goal of <500000 new infections, a 75% reduction compared to 2010. These are ambitious targets for any setting, and achieving them will require the best strategy and science to guide interventions and measure impact.

HIV Treatment guidelines

At this time for PrEP (buy tenvir em online uk) and for the total toolbox of effective HIV prevention strategies. The findings of Volz and colleagues remind us that HIV prevention is about the best prevention plan for an individual, but must also be about prevention for his or her current and future partners and, ultimately, about the population more generally.

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For PrEP, population health benefits can only occur with enough coverage of the population accessing it to result in those key infections prevented to avert subsequent generations of transmissions. We are not there yet. In the United States, PrEP uptake has skyrocketed, with >120000 individuals estimated to have initiated prep hiv pill since 2012 ; still, CDC estimates that 1.2 million persons, including MSM, people who inject drugs, and heterosexual adults, have indications for considering PrEP use. Some geographies are beginning to see PrEP use at levels that should result in population benefits—for example, Seattle and King County, Washington recently reported that one-third of high-risk MSM there are estimated to be on PrEP currently and there are now more people on PrEP in that locality than are taking antiretroviral treatment (and that is in the context of that locality also achieving the UNAIDS goal of 90% of individuals diagnosed, linked to care, and on suppressive antiretroviral therapy). New initiatives related to access to PrEP (as well as treatment and other prevention interventions) in Florida and elsewhere in the southern United States offer encouragement that population benefits may be on the horizon for a part of this country that faces substantial disparity in new HIV infections. The United States accounts for most PrEP use in the world at this time, although the vast majority of new infections occur in low and middle-income countries; UNAIDS has called for 3 million persons to be on PrEP by 2020.