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A key part of HIV control plan is pre-exposure prophylaxis or PrEP, a daily medication to help prevent HIV that is recommended for people at high risk. Recently, the FDA approved a new formulation of PrEP for many — but not all — of those at risk.
PrEP is a daily pill taken to lower a person’s risk for getting HIV. It works best as part of a program of preventive services that includes regular HIV testing. A combination of two antiretroviral medicines (emtricitabine and tenofovir disoproxil fumarate) is more than 90% effective at preventing HIV.
The Centers for Disease Control and Prevention recommend PrEP for those at high risk for HIV, including: men who have sex with men; heterosexual men and women who have high-risk exposure (such as having a partner with known HIV infection, exchanging sex for drugs or money, or having sex with a person at high risk for HIV); people who inject drugs; transgender women.
In August, an FDA advisory panel voted 16 to 2 to recommend a new formulation of PrEP for men who have sex with men and transgender women [emtricitabine and tenofovir alafenamide]. This new formulation is less likely to affect the kidneys and bones. The FDA panel members acknowledged these limitations. Dr. Lindsey Baden, an infectious disease physician at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, noted “we’ve failed women,” and Dr. Roblena Walker, a consumer representative on the panel, voted against approval, citing the poor representation of Black men in the study, calling this “a lost opportunity to provide substantial data reflective of the community that is impacted by HIV.”