PrEP 4 Aug 2022Download this article in PDF format
Recommendations for use in the context of demonstration projects
Globally, 34 million people are living with HIV. A number of HIV prevention methods are available, including male and female condoms, voluntary medical male circumcision, prevention of mother-to-child HIV transmission (PMTCT) and harm reduction strategies such as provision of sterile injecting equipment and opiate substitution therapy for people who inject drugs. All these have contributed to a levelling of the rate of new infections in some countries. Elsewhere, however, the momentum of the epidemic remains strong. In 2010 alone an estimated 2.7 million people became newly infected with HIV. Additional safe and effective approaches to HIV prevention are urgently needed.
The field of HIV prevention, until recently, experienced years of disappointment, as the search for potential vaccines and non-antiretroviral microbicides has yielded little result. Now, however, a promising new approach has emerged: the use of antiretroviral drugs for HIV prevention, both for those uninfected and for those already living with HIV (1–3).
These recommendations have been developed specifically to address the daily use of antiretrovirals in HIV-uninfected people to block the acquisition of HIV infection. This prevention approach is known as pre-exposure prophylaxis (PrEP). At this stage evidence is available from studies with two groups: men and transgender women1 who have sex with men; and serodiscordant heterosexual couples. In parallel, the World Health Organization (WHO) also is preparing new recommendations on the use of antiretroviral drugs in people living with HIV to prevent transmission of infection.