Interim guidance: preexposure prophylaxis for the prevention of HIV infection in men who have sex with men

MMWR Morb Mortal Wkly Rep. 2011 Jan 28;60(3):65-8.

Abstract

An estimated 56,000 human immunodeficiency virus (HIV) infections occur each year in the United States. Men who have sex with men (MSM) account for 53% of the estimated incident infections, and surveillance data suggest that the annual number of new HIV infections among MSM has been rising since the mid-1990s. Strategies for reducing acquisition of HIV infection by MSM have included 1) expanded HIV testing so that infected persons can be treated and their risk for transmitting infection minimized; 2) individual, small-group, and community-level behavioral interventions to reduce risk behaviors; 3) promotion of condom use; 4) detection and treatment of sexually transmitted infections; and 5) mental health and substance abuse counseling when needed. On November 23, 2010, investigators for the Pre-Exposure Prophylaxis Initiative (iPrEX) study announced results from a multinational, randomized, double-blind, placebo-controlled, phase III clinical trial of daily oral antiretrovirals (tenofovir disoproxil fumarate [TDF] and emtricitabine [FTC]) to prevent acquisition of HIV infection among uninfected but exposed MSM. This report provides interim guidance to health-care providers based on the reported results of that trial, which indicated that TDF plus FTC taken orally once a day as preexposure prophylaxis (PrEP) is safe and partially effective in reducing HIV acquisition among MSM when provided with regular monitoring of HIV status and ongoing risk-reduction and PrEP medication adherence counseling.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives*
  • Antiviral Agents / therapeutic use*
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Emtricitabine
  • HIV Infections / prevention & control*
  • Homosexuality, Male*
  • Humans
  • Male
  • Organophosphonates / administration & dosage*
  • Tenofovir
  • Unsafe Sex

Substances

  • Antiviral Agents
  • Organophosphonates
  • Deoxycytidine
  • Tenofovir
  • Emtricitabine
  • Adenine