The U.S. Public Health Service and the Centers for Disease Control and Prevention released guidelines for the use of daily oral antiretroviral pre-exposure prophylaxis, or PrEP, for HIV infection, entitled: Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2014 [PDF 867KB].
These guidelines provide health care providers with recommendations on the use of PrEP to prevent HIV, and include a supplement [PDF 690KB] with additional materials and tools for clinicians who prescribe PrEP and their patients. These guidelines replace previous interim guidance released by CDC for the use of PrEP.
CDC recommends PrEP for HIV-uninfected patients at substantial risk for HIV infection, including patients who have any of the following indications:
- Is in an ongoing relationship with an HIV-infected partner;
- Is not in a mutually monogamous relationship with a partner who recently tested HIV-negative; and is a
- gay or bisexual man who has had sex without a condom or been diagnosed with a sexually transmitted infection within the past six months;
- heterosexual man or woman who does not regularly use condoms when having sex with partners known to be at risk for HIV (e.g., injecting drug users or bisexual male partners of unknown HIV status); or
- Has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.
PrEP is a powerful HIV prevention tool. However, for sexually active people, no prevention strategy is 100% effective. Therefore, the guidelines also recommend that physicians encourage patients to use PrEP with other effective strategies—like using condoms, testing for HIV with partners, reducing the number of partners, and having partners who are HIV positive take antiretroviral therapy—to provide even greater protection from HIV.
To achieve the full promise of PrEP, each of us has a critical role to play. Clinicians play a central role in increasing awareness and the delivery of this new prevention method when there are indications for its use. Advocates can help raise PrEP awareness and understanding about PrEP, especially in at-risk populations. Medical associations and professional organizations can help educate providers and share clinicians’ experiences delivering PrEP, and HIV prevention programs can integrate PrEP education into existing activities.
We mark a milestone with the release of these new guidelines—a promising tool for HIV prevention, and one that has the potential to alter the course of the U.S. HIV epidemic.
For more about PrEP and its use. Please visit the CDC PrEP page.