Year: 2023
Type: article
Abstract: Preexposure prophylaxis (PrEP), the use of highly effective antiretroviral drugs to prevent HIV, is a key component of the Ending the HIV Epidemic Initiative in the US that aims to reduce new HIV cases by 90% by 2030.Although the advent of PrEP carries tremendous potential to change the trajectory of the epidemic, PrEP uptake has been disproportionately low in populations most heavily affected by HIV.In 2021, 78% of White persons expected to benefit from PrEP received it, compared with 11% of Black/African American persons and 21% of Hispanic/Latino persons. 1 Regional disparities exist, with the South accounting for 52% of HIV diagnoses but only 39% of PrEP users.PrEP use has also been substantially lower among cisgender and transgender women, youth, and people who inject drugs. 2 In this issue of JAMA, the US Preventive Services Task Force (USPSTF) releases a new PrEP recommendation, 3 updating its PrEP guidance first published in 2019.4 In 2019, daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) was the only approved medication for PrEP, and the recommendation was given an A recommendation.Since then, 2 new PrEP regimens-daily oral tenofovir alafenamide/emtricitabine (TAF/FTC) and longacting injectable cabotegravir have been approved by the US Food and Drug Administration (FDA).Additionally, several studies have demonstrated high efficacy of event-driven PrEP (taken before and after sex, also known as on-demand or 2-1-1 PrEP) in men who have sex with men, and this regimen has been included in the International AIDS Society-USA and World Health Organization (WHO) guidelines.5,6 The dapivirine vaginal ring has also demonstrated efficacy in trials and, although not FDA approved, has been recommended by
Source: JAMA
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4386046445