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New US guidelines for PrEP target groups

Friday, 16 May, 2014


New guidelines have been set out by the United States Centers for Disease Control and Prevention (CDC) to clarify key groups to be considered for pre-exposure prophylaxis (PrEP). PrEP is a special course of HIV treatment that aims to prevent people from becoming infected with HIV.

The antiretroviral (ARV) drug, Truvada, was licensed in the US as an HIV prevention measure for at-risk HIV-negative people in July 2012, ahead of the AIDS 2012 conference in Washington DC. However, this approval of PrEP by the Food and Drug Adminstration (FDA) was not accompanied by clear guidelines on priority groups to be prescribed the drug.

PrEP is intended for people at-risk of HIV exposure, for example in the case of couples where one partner is HIV-positive and the other is HIV-negative. While it has been argued that PrEP could have a great positive impact on the global HIV epidemic, implementation of a drug of this kind is very expensive and is not viable in many parts of the world.

The CDC’s May 2014 guidelines recommend that PrEP should be considered for the following HIV-negative individuals:

  • Anyone who is in an ongoing sexual relationship with an HIV-infected partner
  • A gay or bisexual man who has had sex without a condom or has been diagnosed with a sexually transmitted infection within the past six months, and is not in a mutually monogamous relationship with a partner who recently tested HIV-negative
  • A heterosexual man or woman who does not always use condoms when having sex with partners known to be at risk for HIV (for example, injecting drug users or bisexual male partners of unknown HIV status), and is not in a mutually-monogamous relationship with a partner who recently tested HIV-negative
  • Anyone who has, within the past six months, injected illicit drugs and shared equipment or been in a treatment program for injection drug use.

It is hoped that these guidelines will give greater clarity and support the effective prescription of PrEP to at-risk groups, and ultimately reduce new HIV infections in the US. Jonathan Mermin, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, commented: “While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the U.S. HIV epidemic today.”