CDC Issues Guidance on Drug for HIV Prevention

Daily pre-exposure prophylaxis may reduce acquisition of HIV in men who have sex with men

THURSDAY, Jan. 27 (HealthDay News) -- Daily pre-exposure prophylaxis (PrEP) with an antiviral medication may reduce the acquisition of HIV in men who have sex with men (MSM), and interim guidance for health care providers on the use of PrEP is published in the Jan. 28 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Dawn K. Smith, M.D., of the CDC in Atlanta, and colleagues based the interim guidance on a trial in which nearly 2,500 MSM without HIV who reported engaging in high-risk sexual activities were randomized to PrEP with daily doses of tenofovir disoproxil fumarate and emtricitabine or placebo.

Participation in the PrEP group was associated with a 44 percent reduction in HIV acquisition. The CDC's new report based on the trial results provides interim guidance for health care providers in the United States for PrEP use until comprehensive U.S. Public Health Service guidelines are available. The report includes guidance on determining PrEP eligibility, beginning a medication regimen, follow-up, and discontinuing PrEP.

"PrEP has the potential to contribute to effective and safe HIV prevention for MSM if 1) it is targeted to MSM at high risk for HIV acquisition; 2) it is delivered as part of a comprehensive set of prevention services, including risk-reduction and PrEP medication adherence counseling, ready access to condoms, and diagnosis and treatment of sexually transmitted infections; and 3) it is accompanied by monitoring of HIV status, side effects, adherence, and risk behaviors at regular intervals," the authors write.

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Physician's Briefing