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Oral tenofovir-based PrEP works. Faster, smarter rollout must be a top priority.

Recent clinical trials have shown clearly that daily, oral pre-exposure prophylaxis (PrEP) using the antiretroviral drugs tenofovir and emtricitabine dramatically reduces the risk of HIV infection for men and women who take it as directed. While PrEP won’t be right for every individual at risk for HIV, untold numbers of men and women will benefit—if they can access this potentially life-saving option.

So far, PrEP’s implementation has been piecemeal and incomplete. TDF/FTC is approved for use as oral PrEP in a handful of countries but, for maximum impact, PrEP rollout needs a coherent, global strategy involving many real-world demonstration projects, other research and guidance from global health agencies. At the same time, research into new PrEP formulations—such as intermittent use of pills or quarterly injections—could help improve adherence and achieve PrEP’s full potential.

What We're Reading

Using data from an annual survey conducted at the Seattle Pride Parade (2009-2015), authors of an article published in AIDS found that PrEP awareness and use among MSM in Seattle, Washington was high in 2015. In 2012 to 2015, among high-risk MSM, PrEP awareness increased from 13 to 86 percent and PrEP use increased from 5 to 31 percent.

January 19, 2016

In this article, by South African researcher Sinead Delaney-Moretlwe and colleagues, the history of the introduction of the oral contraceptive pill in the 1960s is mined for lessons relevant to the introduction of PrEP today. The authors cite concerns over the high cost, potential side-effects and potential for increased sexual promiscuity associated with the oral contraceptive pill, and argue that the novelty alone of a new technology will not spur its adoption, but that success will depend on service delivery systems and invested providers.

January 6, 2016
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