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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

Substantial non‐persistence on PrEP medication in both year one and year two was found. Across the entire 2‐year period, only two out of every five users persisted on PrEP. Demographic, financial and pharmacy factors were associated with persistence. Further research is needed to explore how social, structural or individual factors may undermine or enhance persistence on PrEP, and to develop interventions to assist persistence on PrEP.

February 18, 2019

In 2013, not quite a year after the Food and Drug Administration approved the drug Truvada for HIV prevention, a coalition of 50 experts in HIV and women's health called on U.S. public health agencies to promote the pill and its approach, called pre-exposure prophylaxis, or PrEP, explicitly to women.

February 8, 2019

PrEP can be a valuable tool for women of all experiences who either can’t or don’t want to negotiate condom use with their partners. In July of 2012, the Food and Drug Administration approved Truvada, a daily pill, for PrEP, or pre-exposure prophylaxis, for HIV prevention among adults who are at high risk of getting the infection. Earlier this year, the FDA approved Truvada for PrEP for adolescents. People aged 13 to 24 accounted for 21 percent of new infections in 2016 and the majority of those infections were among black and Hispanic youth.

January 14, 2019

Different expressions are used to describe the process of informal access to antiretroviral drugs (eg, via the Internet or acquaintances) for HIV pre-exposure prophylaxis (PrEP): “informal use”, “informal PrEP”, “off-label PrEP”, “non-prescribed PrEP”, “DIY PrEP”, and “wild PrEP”. This lack of consistent nomenclature makes it difficult to develop an accurate understanding of the nature of the process and its public health implications. To improve consistency for future research and public health initiatives, this process should be referred to as informal PrEP.

December 18, 2018
Lancet Public Health
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