San Francisco, May 14, 2014 — San Francisco AIDS Foundation applauds the U.S. Centers for Disease Control and Prevention (CDC) for releasing new clinical practice guidelines for pre-exposure prophylaxis (PrEP), an HIV prevention strategy in which HIV-negative people take a daily pill to reduce their risk for infection. The new guidelines recommend that health care providers consider PrEP for all patients at substantial risk for HIV, including gay and bisexual men who do not consistently use condoms.
“The CDC’s definitive PrEP guidelines recognize the reality of gay and bi men’s lives and provide a blueprint for providers to explore this new HIV prevention option with those who need it most in our community,” said San Francisco AIDS Foundation CEO Neil Giuliano. “The new guidelines also reflect the tireless efforts of scientists, public health experts, and HIV prevention advocates to increase our understanding of and access to this powerful, evidence-based tool for preventing new HIV infections.”
In July 2012, the U.S. Food and Drug Administration (FDA) approved the drug Truvada for PrEP for use by HIV-negative people at risk for infection—particularly gay and bisexual men. CDC later expanded recommendations around PrEP to include heterosexually active adults at very high risk for infection and people who inject drugs.
The guidance released today improves upon previous interim guidelines by providing clearer criteria for determining who stands to benefit most from PrEP in the context of sexual transmission. Providers are advised to consider PrEP for (1) anyone who is in an ongoing relationship with an HIV-positive partner; (2) gay and bisexual men who have had anal sex without a condom or been diagnosed with an STD in the past six months and who are not in a mutually monogamous relationship with a partner who recently tested HIV negative; and (3) heterosexual women or men who are also not in a mutually monogamous couple with a recently tested HIV-negative partner and who do not regularly use condoms with partners with unknown HIV status and high risk for infection. Providers are also advised to consider PrEP for anyone who has, within the past six months, injected drugs and shared equipment or been in a treatment program for injection drug use.
By presenting more specific criteria for considering PrEP, the new guidance will help providers gain confidence prescribing PrEP and facilitate access for those who need it most. The guidelines also emphasize the need for confirming HIV-negative status before initiating PrEP and for counseling patients about adherence and HIV risk reduction, and recommend regular HIV testing and monitoring for side effects, adherence, and HIV risk behaviors.
“These guidelines are very important and highlight how PrEP could change the course of the epidemic,” said Robert Grant, MD, MPH, the foundation’s chief medical officer and the protocol chair for the Pre-Exposure Prophylaxis Initiative (iPrEx) clinical trial, a multinational study that played a pivotal role in the FDA’s approval of Truvada for PrEP. “Our work to free San Francisco from HIV transmission is stronger than ever.”
To support people in making informed choices around their own sexual health and HIV prevention options, San Francisco AIDS Foundation offers accurate, accessible information and resources on PrEP for both potential users and providers. Visit PrEPfacts.org for educational materials, answers to common PrEP questions, a downloadable brochure with PrEP-related billing codes, and many more materials. For a myth-busting video on PrEP, updates on cutting-edge PrEP science, personal stories and provider perspectives, and other resources, visit BETAblog.org.
About San Francisco AIDS Foundation
No city experienced epidemic levels of HIV faster than San Francisco. At San Francisco AIDS Foundation, we work to end the epidemic where it first took hold, and eventually everywhere. Established in 1982, our mission is the radical reduction of new infections in San Francisco. Through education, advocacy, and direct services for prevention and care, we are confronting HIV in communities most vulnerable to the disease. We refuse to accept that HIV transmission is inevitable.