Task force recommends PrEP for reducing risk for HIV acquisition

The U.S. Preventive Services Task Force (USPSTF) recommends preexposure prophylaxis (PrEP) for reducing the risk for HIV infection among individuals at increased risk for HIV acquisition. This recommendation forms the basis of a draft recommendation statement published online Dec. 13.

Roger Chou, M.D., from the Pacific Northwest Evidence-Based Practice Center at the Oregon Health & Science University in Portland, and colleagues conducted a systematic review on the effects of PrEP on the risk for HIV acquisition, mortality, harms, and other clinical outcomes. The researchers found that in 11 trials involving populations at higher risk for acquiring HIV infection, oral PrEP was associated with a reduced risk for HIV infection versus placebo or no PrEP (relative risk, 0.46).

The effects were consistent across HIV risk categories and for tenofovir disoproxil fumarate (TDF) plus emtricitabine or TDF alone. A strong association was seen between higher adherence and greater efficacy (relative risks, 0.27, 0.51, and 0.93, for adherence ≥70 percent, >40 to <70 percent, and ≤40 percent, respectively). The risk for serious adverse events, sexually transmitted diseases, or adverse pregnancy-related outcomes did not differ for PrEP versus placebo/no PrEP.

Based on these findings, the USPSTF recommends prescribing PrEP to adolescents and adults who are at increased risk for HIV acquisition to reduce the risk for acquiring HIV infection.

The draft evidence review and recommendation statement have been posted for public comment. Comments can be submitted from Dec. 13, 2022, through Jan. 17, 2023.

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