Cross-posted from USPSTF NewsroomExit Disclaimer

Healthcare professionals should prescribe pre-exposure prophylaxis (PrEP) to people at increased risk for HIV

The U.S. Preventive Services Task Force (Task Force) today posted a draft recommendation statement on pre-exposure prophylaxis (PrEP) for the prevention of HIV infection. Based on its review of the evidence, the Task Force recommends that healthcare professionals prescribe PrEP to people at increased risk for HIV to help prevent HIV infection. This is an A grade. Learn more hereExit Disclaimer.

HIV is a virus that attacks cells that help the body fight infection. Though treatable, HIV infection is not curable and can have significant health consequences. 

PrEP is a safe, highly effective way to help prevent HIV in people who do not have HIV but are at increased risk of getting it. PrEP can now be taken as a pill or as a shot. All three FDA-approved PrEP medications are safe and effective. 

PrEP is most effective when taken as prescribed. The Task Force encourages healthcare professionals to help their patients who are on PrEP understand the importance of taking it as prescribed and support them in doing so. 

“Healthcare professionals can help protect their patients at increased risk for HIV by prescribing PrEP,” says Task Force member John B. Wong, M.D. “The availability of multiple effective PrEP medications is great news for patients and a positive step to helping reduce the impact of HIV in the U.S.” 

PrEP is only for people who are at increased risk for HIV. To determine risk, healthcare professionals need to talk with all their patients about their sexual history and ask about injection drug use in an open and supportive way. Factors that increase a person’s risk for HIV include having sex with someone who has HIV; having a recent STI; not using condoms consistently, especially with partners who are at increased risk; and sharing drug injection needles. 

Black and Hispanic/Latino people are more likely to be diagnosed with HIV yet have much lower rates of PrEP use than White people. Healthcare professionals need to be aware that barriers to the use of PrEP exist and provide support to patients at increased risk in these communities to start and stay on PrEP. The Task Force is calling for more research on how to reduce barriers in these and other communities impacted by HIV. 

“Many people who would benefit from PrEP are not receiving this highly effective medication. This is especially true of Black, Hispanic, and Latino communities,” says Task Force member Martha Kubik, Ph.D., R.N. “These inequities must be addressed to achieve the full benefit of PrEP.” 

It is important that people who take PrEP continue to use condoms, practice other safer sex behaviors, and be tested for HIV and other STIs regularly.

The Task Force’s draft recommendation statement and draft evidence review have been posted for public comment on the Task Force website at submitted from https://www.uspreventiveservicestaskforce.orgExit Disclaimer. Comments can be submitted from December 13, 2022, through January 17, 2023, at https://www.uspreventiveservicestaskforce.org/tfcomment.htmExit Disclaimer.

The Task Force is an independent, volunteer panel of national experts in prevention and evidence medicine that works to improve the health of people nationwide by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.

Dr. Wong is vice chair for Academic Affairs, chief of the Division physician of Clinical Decision Making, and a primary care physician in the department of medicine at Tufts Medical Center. He is also a professor of medicine at Tufts University School of Medicine and a master of the American College of Physicians.

Dr. Kubik is a professor with the School of Nursing, College of Health and Human Services at George Mason University. She is a nurse scientist, active researcher, and past standing member on the National Institutes of Health’s Community Level Health Promotion Study Section. Dr. Kubik is an advanced practice nurse and fellow of the American Academy of Nursing.