On May 14th the CDC and DHHS released the first Clinical Practice Guidelines for Pre Exposure Prophylaxis (PrEP) for HIV prevention in the United States.
The guidelines recommend Truvada ( tenofovir/emtricitabine) for PrEP. When taken consistently PrEP reduces the risk of HIV infection up to 92% in people who are at high risk. Adherence is therefore absolutely crucial in people who elect to start taking Truvada for PrEP.
The new guidelines are for people who are HIV negative and at substantial risk for HIV
1. For Sexual Transmission
Anyone who is in a relationship with an HIV positive partner and includes
- anyone who is not mutually monogamous with a partner who recently tested HIV negative
- gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months
- heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk for HIV infection
2. For people who inject drugs including those who have injected illicit drugs in the past 6 months and who have shared injection equipment or been in drug treatment for injection drug use in the past 6 months.
3. Serodiscordant couples
In addition to the guidelines, a Clinical Provider’s Supplement has been created that contains patient and provider information including a patient/provider checklist
As pharmacists we can play an important role in the education of both patients and providers regarding HIV prevention and counseling on medication adherence to ensure maximal protection for PrEP
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