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Review
. 2013 Jul;63 Suppl 2(0 2):S122-9.
doi: 10.1097/QAI.0b013e3182986f69.

Preexposure prophylaxis for HIV prevention: where have we been and where are we going?

Jared M Baeten  1 , Jessica E Haberer, Albert Y Liu, Nirupama Sista
Affiliations
Review

Preexposure prophylaxis for HIV prevention: where have we been and where are we going?

Jared M Baeten et al. J Acquir Immune Defic Syndr. 2013 Jul.

Abstract

Preexposure prophylaxis (PrEP), in which HIV-uninfected persons with ongoing HIV risk use antiretroviral medications to reduce their risk of acquiring HIV infection, is an efficacious and promising new HIV prevention strategy. The past 2 years have seen significant new advances in knowledge regarding PrEP, including definitive demonstration that PrEP reduces the risk of HIV acquisition, regulatory approval of combination oral emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) as the first PrEP agent with a label indication for sexual HIV prevention, and the development of normative guidance for clinical prescribing of PrEP. In PrEP clinical trials, HIV protection was strongly correlated with PrEP adherence; therefore, understanding and supporting adherence to PrEP are key to maximizing its public health impact. As would be expected for any new HIV prevention approach, questions remain, including how to motivate uptake of and sustain adherence to PrEP for HIV prevention in high-risk populations, how much use is sufficient to achieve HIV protection, and the potential of "next-generation" PrEP agents to improve this effective prevention strategy. At this important transition point-from demonstration of efficacy in clinical trials to thinking about implementation and effectiveness-this review addresses where we have been and where we are going with PrEP for HIV prevention.

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Conflict of interest statement

Conflicts: Sista: owns personal stock as investment in Gilead Sciences; Pfizer, other pharma

Haberer: Received funding for research from IAVI on pre-exposure prophylaxis against HIV infection. This work informed some of my contributions to the submitted manuscript, but did not support the manuscript directly. Recieved salary support from Mass General for clinical care, which is unrelated to the submitted manuscript. Receives funding from Gates Foundation for research on pre-exposure prophylaxis against HIV infection. This work informed some of my contributions to the submitted manuscript, but did not support the manuscript directly. Received a small honorarium for speaking at an IAPAC conference, which was unrelated to the submitted manuscript. Received a small honorarium and travel expenses for speaking at a UW course, which was unrelated to the submitted manuscript. Received Natera stock options as a consultant. This work was unrelated to the submitted manuscript. Received a small honorarium from Harvard CFAR for participating in a CFAR grant review, which was unrelated to the submitted manuscript. Received a small honorarium and travel expenses for participating in an NICHD grant review, which was unrelated to the submitted manuscript. Received a small honorarium and travel expenses for participating in an AHRQ technical expert panel, which was unrelated to the submitted manuscript. Received a small honorarium and travel expenses from FHI 360 for providing consultation on a pre-exposure prophylaxis study. This work informed some of my contributions to the submitted manuscript, but did not support the manuscript directly.

References

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