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A community perspective on pre-exposure prophylaxis.

Simon Collins1

  • 1HIV i-Base, London, UK.

Journal of the International AIDS Society
|November 14, 2014
PubMed
Summary
This summary is machine-generated.

Pre-exposure prophylaxis (PrEP) development was community-led, facing challenges despite proven HIV prevention effectiveness. Future access may improve with generic options and long-acting formulations.

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Area of Science:

  • Public Health
  • HIV Prevention
  • Community Health

Background:

  • Pre-exposure prophylaxis (PrEP) development was primarily driven by community demand, not industry interests.
  • Despite increasing evidence of PrEP's effectiveness, its integration into healthcare settings has faced challenges and controversies.
  • The persistent rates of new HIV infections in high-risk populations highlight the limitations of existing prevention methods like condoms.

Purpose of the Study:

  • To review the history and development of PrEP, including community involvement, study outcomes, regulatory hurdles, and public health implications.
  • To examine controversies limiting PrEP access and changes since its US approval in 2012.
  • To explore the evolving dialogue around PrEP and treatment as prevention (TasP) concerning quality of life and reducing HIV-related fear.

Main Methods:

  • Historical review of PrEP development, encompassing community demand, research findings, regulatory processes, and commercial factors.
  • Analysis of public health challenges and controversies impacting PrEP accessibility.
  • Examination of shifts in the PrEP debate towards individual choice and its intersection with TasP.

Main Results:

  • PrEP's development pathway was community-driven, contrasting with typical industry-led pharmaceutical advancements.
  • Willingness to adopt PrEP in some health settings appears inversely related to its demonstrated effectiveness.
  • The debate surrounding PrEP is moving towards a consensus focused on individual choice, alongside TasP.

Conclusions:

  • PrEP's history underscores the significant role of community advocacy in public health innovation.
  • Overcoming barriers related to cost and adherence, potentially through generic tenofovir and long-acting formulations, is crucial for broader PrEP implementation.
  • Integrating PrEP with TasP offers a new perspective on improving the quality of life for individuals at risk of HIV infection.