Learn About PrEP | Preventing New HIV Infections | Clinicians | HIV | CDC - ISS-G20 Laboratorium Repository

What is PrEP?

PrEP is short for pre-exposure prophylaxis. It is the use of antiretroviral medication to prevent HIV infection. PrEP is used by people without HIV who may be exposed to HIV through sex or injection drug use.

The US Food and Drug Administration (FDA) has approved three medications for use as PrEP, which are listed below. Two consist of a combination of drugs in a single oral tablet taken daily. The third medication is a medicine given by injection every 2 months.

1. Emtricitabine (F) 200 mg in combination with tenofovir disoproxil fumarate (TDF) 300 mg (F/TDF – brand name Truvada® or generic equivalent).
2. Emtricitabine (F) 200 mg in combination with tenofovir alafenamide (TAF) 25 mg (F/TAF – brand name Descovy®).
3. Cabotegravir (CAB) 600 mg injection (brand name Apretude®).

These medications are approved to prevent HIV infection in adults and adolescents weighing at least 35 kg (77 lb) as follows:

• Daily oral PrEP with F/TDF is recommended to prevent HIV infection among all people at risk through sex or injection drug use.
• Daily oral PrEP with F/TAF is recommended to prevent HIV infection among people at risk through sex, excluding people at risk through receptive vaginal sex. F/TAF has not yet been studied for HIV prevention for people assigned female at birth who could get HIV through receptive vaginal sex.
• Injectable PrEP with CAB is recommended to prevent HIV infection among all people at risk through sex. It may be especially useful for people who have problems taking oral PrEP as prescribed, who prefer getting a shot every 2 months instead of taking oral PrEP, or who have serious kidney disease that prevents use of oral PrEP medications.

PrEP should be considered part of a comprehensive prevention plan that includes a discussion about adherence to PrEP, condom use to prevent getting other sexually transmitted infections (STIs), and other risk-reduction methods.

What are the guidelines for prescribing PrEP?

The Centers for Disease Control and Prevention (CDC) has published comprehensive guidelines for prescribing PrEP in A Clinical Practice Guideline for PrEP pdf icon[PDF – 1.6 MB],[1] including a Clinical Providers’ Supplement for PrEP pdf icon[PDF – 809 KB].[2]

The Clinical Providers’ Supplement for PrEP pdf icon[PDF – 809 KB] contains additional tools for health care providers providing PrEP, such as patient/provider checklists; patient information sheets; provider information sheets; HIV risk screening assessments for gay, bisexual, and other men who have sex with men (collectively referred to as MSM) and people who inject drugs; supplemental counseling information; billing codes; and practice quality measures. Health care providers who have questions about PrEP or would like advice about prescribing PrEP or HIV testing should consult the National Clinicians Consultation Center PrEPline at 1-855-448-7737 (9:00 AM – 8:00 PM EST).

The US Preventive Services Task Force has given oral PrEP a grade A recommendation.[3] This grade indicates that their review found high certainty that the net benefit of this service is substantial. For more information, view the full recommendation rationale at: https://www.uspreventiveservicestaskforce.org/‌uspstf/‌recommendation/‌prevention-of-human-immunodeficiency-virus-hiv-‌infection-pre-exposure-prophylaxisexternal icon.

Who can prescribe PrEP?

Any licensed prescriber can prescribe PrEP. The provider does not have to specialize in infectious diseases or HIV medicine. PrEP is a primary care preventive service that should be offered by any prescriber who cares for people without HIV.

To whom should I offer PrEP?

Providers should tell all their sexually active patients about PrEP and how it can protect them from getting HIV. Telling all sexually active patients about PrEP will increase the number of people who know about PrEP and may also help patients overcome embarrassment or stigma that may prevent them from telling their health care provider about behaviors that put them at risk for getting HIV.[4-9] Providers should prescribe PrEP to anyone who asks for it, including sexually active adults and adolescents who do not report behaviors that put them at risk for getting HIV.

Whether or not a patient asks for PrEP, it is important to take a sexual and substance use history. This information is essential to understand each patient’s risk of getting HIV, if PrEP might be right for them, and what other risk-reduction services should be offered. Providers can use the following flowcharts to assess patients before offering PrEP.

Entire content available on: https://www.cdc.gov/hiv/clinicians/prevention/prep.html