Update on HIV prevention and preexposure prophylaxis.

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• HIV remains a significant public health concern in the US, with 40,000 annual infections.
• HIV preexposure prophylaxis (PrEP) offers a biomedical intervention to prevent HIV acquisition in at-risk populations.

Purpose of the Study:

• To provide clinicians with a foundational understanding of PrEP indications, prescribing guidelines, and monitoring protocols.
• To review existing and newly approved PrEP medications, including emtricitabine/tenofovir alafenamide (F/TAF).
• To emphasize the importance of risk assessment based on behavior rather than population characteristics, particularly for sexual and gender minorities.

Main Methods:

• Literature review of current PrEP guidelines and approved medications.
• Analysis of prescribing and monitoring practices for PrEP.
• Discussion of considerations for specific populations, including sexual and gender minorities.

Main Results:

• PrEP is an effective tool for HIV prevention when prescribed and monitored appropriately.
• Emtricitabine/tenofovir alafenamide (F/TAF) is a newly approved option for PrEP.
• Behavioral risk assessment is crucial for effective PrEP implementation.

Conclusions:

• Clinicians, including PAs, have a critical role in managing PrEP to reduce HIV transmission.
• Understanding PrEP indications, medications, and monitoring is essential for effective HIV prevention strategies.
• Tailoring PrEP guidance to individual behaviors ensures equitable and effective care.