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Published on: January 31, 2020
Pre-exposure prophylaxis of HIV
1Department of Skin VD, Government Medical College and SSG Hospital, Vadodara, India.
Indian Journal of Sexually Transmitted Diseases and AIDS
|July 30, 2011
Summary
Pre-exposure prophylaxis (PrEP) offers a new way to prevent HIV using antiretroviral drugs taken before potential exposure. This approach can significantly reduce HIV incidence, especially for women and men who have sex with men.
Area of Science:
- Infectious Diseases
- Public Health
- Pharmacology
Background:
- Pre-exposure prophylaxis (PrEP) involves antiretroviral drugs taken before potential HIV exposure to reduce infection risk.
- Women constitute a significant portion of adult HIV infections, and PrEP offers a female-controlled prevention method.
- Current trials focus on daily oral tenofovir disoproxil fumarate (TDF) alone or with emtricitabine (FTC).
Purpose of the Study:
- To evaluate the efficacy and potential of PrEP as an additional HIV prevention strategy.
- To highlight PrEP's role as a female-controlled method for women unable to negotiate condom use.
- To review ongoing and future trials exploring various PrEP delivery methods.
Main Methods:
- Clinical trials investigating daily oral antiretroviral drugs (TDF, TDF/FTC) for HIV prevention.
- Analysis of data from ongoing studies like the iPrex trial, Bangkok Tenofovir Study, Partners PrEP, FEM-PrEP, and VOICE (MTN-003).
- Exploration of future PrEP strategies including intermittent dosing and alternative delivery routes (vaginal, rectal).
Main Results:
- The iPrex trial demonstrated a 44% reduction in HIV incidence among men who have sex with men (MSM) using daily TDF/FTC.
- Interim guidance from the CDC recommends PrEP for MSM based on trial outcomes.
- Ongoing research continues to assess PrEP's effectiveness across diverse populations and delivery methods.
Conclusions:
- PrEP shows significant potential as an HIV prevention tool, particularly for at-risk populations.
- Effective PrEP implementation requires integration into a comprehensive prevention toolkit, including risk reduction and STI management.
- Addressing concerns such as adherence, acceptability, side effects, and cost is crucial for successful PrEP deployment.
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