Pre-Exposure Prophylaxis (PrEP) for HIV Prevention: Promoting Safe and Effective Use in the United States
Developing Formal U.S. Public Health Service Guidelines on PrEP Use
CDC is the lead federal agency in developing U.S. Public Health Service guidelines, in collaboration with other federal health agencies. The guidelines will be based on a full review of trial data and other research, and will incorporate input from providers, HIV prevention partners, and affected communities. The guidelines will help ensure both physicians and MSM have accurate information to guide decisions about the use of PrEP.
Topics to be addressed in the guidelines will include:
Maximizing the Potential Benefits of PrEP in the U.S.
The iPrEx trial findings offer a new tool to help combat HIV among MSM, one of the hardest hit populations in the U.S. and many areas of the world.
We will have to carefully consider how to most effectively use this tool in combination with other prevention strategies to reduce the continuing toll of HIV and AIDS. There are a significant number of HIV-positive individuals in the U.S. and around the world who do not have access to antiretroviral drugs to treat their infection, and we know that treatment not only benefits infected individuals, but can also reduce transmission of HIV to others. But, we also know that treatment alone will not end the epidemic. With 2.7 million people becoming infected annually worldwide, including approximately 56,000 in the U.S., we must capitalize on every available prevention tool.
Ultimately, the impact of PrEP on the U.S. HIV epidemic will depend on difficult decisions and many things that remain unknown, including the feasibility, cost, and impact of this strategy in real-world settings.
Available data suggest that PrEP, used strategically and effectively among MSM, could have a positive impact on the U.S. epidemic and be cost-effective, but only if certain conditions are met, including:
CDC's Next Steps
CDC will be implementing a range of activities to promote the effective and strategic use of PrEP in the U.S. In addition to developing public health guidelines, CDC will:
CDC has also identified other activities that could help address remaining research questions and is currently exploring all avenues to identify resources to support them. Key among these is the need for demonstration projects in clinics serving MSM to assess feasibility, acceptability, and the impact of PrEP in real-world settings. It will also be critical for public and private sector partners to begin to collectively address the significant financial barriers that may place PrEP out of reach for many MSM at highest risk for HIV infection.
Given the urgency of addressing the HIV epidemic among gay and bisexual men in this nation, CDC is working to maximize the impact of this important new intervention in combination with all available HIV prevention strategies.
For more information on PrEP and HIV prevention, please visit www.cdc.gov/hiv/prep.
This article was provided by U.S. Centers for Disease Control and Prevention. Visit the CDC's website to find out more about their activities, publications and services.
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