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HIV Preexposure Prophylaxis

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2. Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis

Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis Final Update Summary: Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 5/9/2019 1:01:08 PM You are here: Final Summary YouTube embedded video: https://www.youtube-nocookie.com/embed/guahk43RkV4 Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure (...) Prophylaxis Release Date: June 2019 Recommendation Summary Population Recommendation Grade Persons at high risk of HIV acquisition The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition. To read the recommendation statement in JAMA , select . To read the evidence summary in JAMA , select . See the for information about identification of persons at high risk and selection of effective antiretroviral

2019 U.S. Preventive Services Task Force

3. Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. (PubMed)

Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. Emerging evidence suggests that risk of bacterial sexually transmitted infections (STIs) increases among gay and bisexual men following initiation of HIV preexposure prophylaxis (PrEP).To describe STI incidence and behavioral risk factors among a cohort of predominantly gay and bisexual men who use PrEP, and to explore changes in STI incidence following (...) PrEP commencement.The Pre-exposure Prophylaxis Expanded (PrEPX) Study, a multisite, open-label intervention study, was nested within the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) clinic network. A total of 4275 participants were enrolled (July 26, 2016-April 1, 2018) in Victoria, Australia. Of these, 2981 enrolled at 5 ACCESS clinics (3 primary care, 1 sexual health, and 1 community-based HIV rapid testing service), had at least 1 follow-up visit, and were

2019 JAMA

4. Preexposure Prophylaxis for Mitigating Risk of HIV Transmission During HIV Cure-Related Clinical Trials With a Treatment Interruption. (PubMed)

Preexposure Prophylaxis for Mitigating Risk of HIV Transmission During HIV Cure-Related Clinical Trials With a Treatment Interruption. Analytical treatment interruption performed during human immunodeficiency virus (HIV) cure-related clinical trials exposes sex partners of participants in these trials to a risk of HIV transmission. Preexposure prophylaxis (PrEP), which emerged in recent years as a key strategy for preventing HIV transmission, is often considered a useful tool to prevent

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2019 Journal of Infectious Diseases

5. HIV Preexposure Prophylaxis: A Review. (PubMed)

HIV Preexposure Prophylaxis: A Review. About 40 000 Americans and 2 million people worldwide are newly infected with HIV each year. The combination antiretroviral regimen, tenofovir disoproxil fumarate (TDF)/emtricitabine, taken as a single pill once daily, has been shown to prevent HIV transmission but is used by fewer than 20% of people who could benefit in the United States.PubMed was searched on February 15, 2018, using the search terms pre-exposure, prophylaxis, HIV, and PrEP to identify (...) English-language articles published between 2010 and 2018. Four placebo-controlled randomized clinical trials have demonstrated that preexposure prophylaxis (PrEP) with daily dosing of TDF/emtricitabine significantly reduces HIV acquisition in men who have sex with men, high-risk heterosexuals, and injection drug users who share injection equipment. The efficacy of daily TDF/emtricitabine exceeds 90% but is highly correlated with degree of adherence. TDF/emtricitabine is safe and well-tolerated. Only

2018 JAMA

6. A systematic review of the correlates to preexposure prophylaxis (PrEP) awareness and knowledge among populations at risk of HIV in the United States

A systematic review of the correlates to preexposure prophylaxis (PrEP) awareness and knowledge among populations at risk of HIV in the United States Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

7. Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men. (PubMed)

Individual HIV Risk versus Population Impact of Risk Compensation after HIV Preexposure Prophylaxis Initiation among Men Who Have Sex with Men. Risk compensation (RC) could reduce or offset the biological prevention benefits of HIV preexposure prophylaxis (PrEP) among those at substantial risk of infection, including men who have sex with men (MSM). We investigated the potential extent and causal mechanisms through which RC could impact HIV transmission at the population and individual (...) levels.Using a stochastic network-based mathematical model of HIV transmission dynamics among MSM in the United States, we simulated RC as a reduction in the probability of condom use after initiating PrEP, with heterogeneity by PrEP adherence profiles and partnership type in which RC occurred. Outcomes were changes to population-level HIV incidence and individual-level acquisition risk.When RC was limited to MSM highly/moderately adherent to PrEP, 100% RC (full replacement of condoms) resulted in a 2

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2017 PLoS ONE

8. Patterns and clinical consequences of discontinuing HIV preexposure prophylaxis during primary care. (PubMed)

Patterns and clinical consequences of discontinuing HIV preexposure prophylaxis during primary care. Discontinuations of HIV preexposure prophylaxis (PrEP) by at-risk individuals could decrease the effectiveness of PrEP. Our objective was to characterize patterns of, reasons for, and clinical outcomes associated with PrEP discontinuations in primary care.We conducted medical chart reviews for patients prescribed PrEP during 2011 to 2014 at a Boston community health centre specializing (...) in healthcare for sexual and gender minorities. Patients were followed through 2015. We characterized patients' sociodemographics, relationship status, behavioural health conditions, patterns of and reasons for PrEP discontinuations, and HIV seroconversions. Cox proportional hazards models were used to assess patient factors associated with PrEP discontinuations.Of the 663 patients prescribed PrEP, the median age was 33 years, 96% were men who have sex with men (MSM) and 73% were non-Hispanic white; 40

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2019 Journal of the International AIDS Society

9. Persistence on HIV preexposure prophylaxis medication over a 2-year period among a national sample of 7148 PrEP users, United States, 2015 to 2017. (PubMed)

Persistence on HIV preexposure prophylaxis medication over a 2-year period among a national sample of 7148 PrEP users, United States, 2015 to 2017. Persistence on preexposure prophylaxis for HIV prevention (PrEP) medication has rarely been reported for periods greater than one year, or in real-world settings. This study used pharmacy fill records for PrEP users from a national chain pharmacy to describe persistence on PrEP medication over a two-year period, and to explore correlates with PrEP

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2019 Journal of the International AIDS Society

10. Addressing Gaps in HIV Preexposure Prophylaxis Care to Reduce Racial Disparities in HIV Incidence in the United States. (PubMed)

Addressing Gaps in HIV Preexposure Prophylaxis Care to Reduce Racial Disparities in HIV Incidence in the United States. The potential for HIV preexposure prophylaxis (PrEP) to reduce the racial disparities in HIV incidence in the United States may be limited by racial gaps in PrEP care. We used a network-based mathematical model of HIV transmission for younger black and white men who have sex with men (B/WMSM) in the Atlanta area to evaluate how race-stratified transitions through the PrEP care (...) continuum from initiation to adherence and retention could impact HIV incidence overall and disparities in incidence between races, using current empirical estimates of BMSM continuum parameters. Relative to a no-PrEP scenario, implementing PrEP according to observed BMSM parameters was projected to yield a 23% decline in HIV incidence (HR = 0.77) among BMSM at year 10. The racial disparity in incidence in this observed scenario was 4.95 per 100 person-years at risk (PYAR), a 19% decline from the 6.08

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2018 American Journal of Epidemiology

11. Correction for Lund et al., HIV-1-Neutralizing IgA Detected in Genital Secretions of Highly HIV-1-Exposed Seronegative Women on Oral Preexposure Prophylaxis (PubMed)

Correction for Lund et al., HIV-1-Neutralizing IgA Detected in Genital Secretions of Highly HIV-1-Exposed Seronegative Women on Oral Preexposure Prophylaxis 28100808 2018 04 07 1098-5514 91 3 2017 02 01 Journal of virology J. Virol. Correction for Lund et al., HIV-1-Neutralizing IgA Detected in Genital Secretions of Highly HIV-1-Exposed Seronegative Women on Oral Preexposure Prophylaxis. e02074-16 10.1128/JVI.02074-16 Lund Jennifer M JM Vaccine and Infectious Disease Division, Fred Hutchinson

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2017 Journal of virology

12. Hepatitis C virus incidence in HIV-infected and in preexposure prophylaxis (PrEP)-using men having sex with men. (PubMed)

Hepatitis C virus incidence in HIV-infected and in preexposure prophylaxis (PrEP)-using men having sex with men. HCV incidence still appears on the rise in HIV-infected MSM in France. We assessed the incidence of HCV infection in HIV-positive and in preexposure prophylaxis (PrEP)-using MSM.HIV-infected, HCV-negative MSM with serological follow-up in 2016 and HIV-negative, HCV-negative PrEP-using MSM enrolled from January 2016 to May 2017 in the French Dat'AIDS cohort were analyzed to assess (...) the incidence of a primary HCV infection. The incidence of HCV reinfection was also determined in patients having cured a previous infection.Among 10,049 HIV-infected MSM followed in 2016, 681 patients were already HCV-infected when entering the study (prevalence 6.8%). Serological follow-up was available in 2016 for 4,151 HCV-negative patients. Virological follow-up was available for 478 patients who had cured a previous infection. Fifty-seven HCV infections occurred in 2016 (42 primary infections, 15

2018 Liver International

13. Pregnancy outcomes and infant growth among babies with in-utero exposure to tenofovir-based preexposure prophylaxis for HIV prevention. (PubMed)

Pregnancy outcomes and infant growth among babies with in-utero exposure to tenofovir-based preexposure prophylaxis for HIV prevention. Global guidelines recommend preexposure prophylaxis (PrEP) use by women at risk for HIV, including during pregnancy, a period with heightened HIV risk. However, data to support safety of PrEP use during pregnancy are limited, particularly from women using PrEP throughout pregnancy.In an open-label delivery study of PrEP integrated with ART for high-risk HIV

2018 AIDS

14. Costs and benefits of on-demand HIV preexposure prophylaxis in MSM. (PubMed)

Costs and benefits of on-demand HIV preexposure prophylaxis in MSM. We undertook the economic evaluation of the double-blind randomized ANRS-IPERGAY trial, which showed the efficacy of on-demand preexposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF)-emtricitabine (FTC) in preventing HIV infection among high-risk MSM.The economic evaluation was prospective. Counseling, drugs (TDF-FTC at &OV0556;500.88 for 30 tablets), tests, visits, and hospital admissions were valued based (...) on in-trial use. The cost of on-demand PrEP/HIV infection averted was compared with the yearly and lifetime costs of HIV infection in France in a cost and benefits analysis.The yearly number of participants needed to treat to prevent one HIV infection was 17.6 (95% confidence interval = 10.7-49.9). The annual cost of counseling was &OV0556;690/participant. The total 1-year costs of PrEP were &OV0556;4271/participant, of which &OV0556;3129 (73%) were drug costs corresponding to 15 tablets of TDF-FTC/month

2018 AIDS

15. In what circumstances could nondaily preexposure prophylaxis for HIV substantially reduce program costs? (PubMed)

In what circumstances could nondaily preexposure prophylaxis for HIV substantially reduce program costs? To review the main factors influencing the costs of nondaily oral preexposure prophylaxis (PrEP) with tenofovir (±emtricitabine). To estimate the cost reductions possible with nondaily PrEP compared with daily PrEP for different populations (MSM and heterosexual populations).Systematic review and data triangulation.We estimated the required number of tablets/person/week for dosing regimens

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2018 AIDS

16. Cost-Effectiveness of HIV Preexposure Prophylaxis for People Who Inject Drugs in the United States. (PubMed)

Cost-Effectiveness of HIV Preexposure Prophylaxis for People Who Inject Drugs in the United States. The total population health benefits and costs of HIV preexposure prophylaxis (PrEP) for people who inject drugs (PWID) in the United States are unclear.To evaluate the cost-effectiveness and optimal delivery conditions of PrEP for PWID.Empirically calibrated dynamic compartmental model.Published literature and expert opinion.Adult U.S. PWID.20 years and lifetime.PrEP alone, PrEP with frequent (...) screening (PrEP+screen), and PrEP+screen with enhanced provision of antiretroviral therapy (ART) for individuals who become infected (PrEP+screen+ART). All scenarios are considered at 25% coverage.Infections averted, deaths averted, change in HIV prevalence, discounted costs (in 2015 U.S. dollars), discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios.PrEP+screen+ART dominates other strategies, averting 26 700 infections and reducing HIV prevalence among PWID by 14

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2016 Annals of Internal Medicine

17. Optimizing Delivery of HIV Preexposure Prophylaxis for Women in the United States (PubMed)

Optimizing Delivery of HIV Preexposure Prophylaxis for Women in the United States Preexposure prophylaxis (PrEP) is a highly effective HIV prevention method; however, it is underutilized among women who are at risk for acquisition of HIV. Women comprise one in five HIV diagnoses in the United States, and significant racial disparities in new HIV diagnoses persist. The rate of new HIV diagnoses among black and African American women in 2015 was 16 times greater than that of white women (...) . These disparities highlight the importance of HIV prevention strategies for women, including the use of PrEP. PrEP is the first highly effective HIV prevention method available to women that is entirely within their control. However, because so few women who may benefit from PrEP are aware of it, few women's healthcare providers offer PrEP to their patients, PrEP has not yet achieved its potential to reduce HIV infections in women. This article describes individual and systemic barriers for women related

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2018 AIDS patient care and STDs

18. Maximizing the Benefits of HIV Preexposure Prophylaxis (PubMed)

Maximizing the Benefits of HIV Preexposure Prophylaxis Preexposure prophylaxis (PrEP) with tenofovir/emtricitabine (slash indicates coformulation) is highly effective in preventing new HIV infections. PrEP efficacy is strongly associated with adherence. In clinical trials, PrEP has been more effective in men who have sex with men and HIV-serodiscordant heterosexual couples than in women, likely reflecting pharmacokinetic differences between levels of tenofovir disoproxil fumarate in vaginal (...) and Latino individuals. This article summarizes a presentation by Susan P. Buchbinder, MD, at the IAS-USA continuing education program, Improving the Management of HIV Disease, held in Chicago, Illinois, in May 2017.

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2018 Topics in antiviral medicine

19. Empowering With PrEP (E-PrEP), a Peer-Led Social Media–Based Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized Controlled Trial (PubMed)

Empowering With PrEP (E-PrEP), a Peer-Led Social Media–Based Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized Controlled Trial Young black and Latinx, gay, bisexual, and other men who have sex with men (YBLGBM, aged 18-29 years) have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions. Preexposure prophylaxis (...) (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM. Use of social media (eg, Facebook, Twitter, online dating sites) is ubiquitous among young people, providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption.Our overall goal was to develop and pilot test a theoretically grounded, social media-based, peer-led intervention

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2018 JMIR Research Protocols

20. HIV Preexposure Prophylaxis, by Race and Ethnicity — United States, 2014–2016 (PubMed)

HIV Preexposure Prophylaxis, by Race and Ethnicity — United States, 2014–2016 Preexposure prophylaxis (PrEP) with a daily, oral pill containing antiretroviral drugs is highly effective in preventing acquisition of human immunodeficiency virus (HIV) infection (1-4). The combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is the only medication approved by the Food and Drug Administration (FDA) for PrEP. PrEP is indicated for men and women with sexual or injection drug (...) use behaviors that increase their risk for acquiring HIV (5). CDC analyzed 2014-2016 data from the IQVIA Real World Data - Longitudinal Prescriptions (IQVIA database) to estimate the number of persons prescribed PrEP (users) in the United States and to describe their demographic characteristics, including sex and race/ethnicity. From 2014 to 2016, the annual number of PrEP users aged ≥16 years increased by 470%, from 13,748 to 78,360. In 2016, among 32,853 (41.9%) PrEP users for whom race

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2018 Morbidity and Mortality Weekly Report

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