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Updated guidelines on HIV post-exposure prophylaxis: continued efforts towards increased accessibility.

Lao-Tzu Allan-Blitz1,2, Kenneth H Mayer2,3,4,5

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Summary

The updated World Health Organization (WHO) guidelines for post-exposure prophylaxis (PEP) aim to increase access by recommending community-based delivery and task sharing with non-specialist health workers. These changes address barriers and improve HIV prevention efforts.

Keywords:
HIV PEPHIV post‐exposure prophylaxisHIV preventionWorld Health Organizationguidelinespolicy

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Area of Science:

  • Public Health
  • Infectious Disease Prevention
  • Global Health Policy

Background:

  • HIV transmission persists globally, despite the availability of post-exposure prophylaxis (PEP).
  • Significant underutilization of PEP is attributed to barriers like low awareness, limited access, and stigma.
  • The World Health Organization (WHO) has released updated guidance to improve HIV PEP delivery.

Purpose of the Study:

  • To highlight key changes in the 2024 WHO PEP guidelines.
  • To evaluate how these recommendations can overcome existing barriers to PEP implementation.
  • To discuss strategies for practical implementation of the updated guidance.

Main Methods:

  • Commentary on the updated WHO guidelines for HIV post-exposure prophylaxis (PEP).
  • Analysis of recommendations for community-based delivery and task sharing.
  • Discussion of strategies to address implementation challenges and support adherence.

Main Results:

  • The 2024 WHO PEP guidelines strongly recommend community-based delivery (pharmacies, online platforms) and task sharing with non-specialist health workers.
  • Decentralized PEP delivery aims to reduce initiation time, overcome barriers, and improve adherence.
  • The guidelines emphasize PEP encounters as opportunities to discuss pre-exposure prophylaxis (PrEP) for individuals at ongoing risk.

Conclusions:

  • Updated WHO PEP guidelines significantly enhance access to HIV prevention.
  • Decentralization and task sharing are key strategies to address PEP underutilization.
  • Successful implementation requires further work, including detailed templates, workforce training (trauma-informed care), and evaluation of novel delivery methods.