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Antiretrovirals for Primary HIV Prevention: the Current Status of Pre- and Post-exposure Prophylaxis

  • The Science of Prevention (JD Stekler, Section Editor)
  • Published:
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Abstract

In light of the 2 million HIV infections that occur globally each year, there is a need to optimize strategies that integrate biomedical and behavioral approaches to HIV prevention. Post-exposure prophylaxis (PEP) immediately after acute high-risk exposures and pre-exposure prophylaxis (PrEP) for those who engage in recurrent high-risk behaviors are promising bio-behavioral approaches to decreasing HIV transmission. Guidelines have recommended PEP for occupational and non-occupational exposures for over 15 years, but uptake of PEP has been limited, partly as a result of insufficient awareness of this intervention among persons at highest risk for acquiring HIV. However, since the publication of large randomized clinical trials demonstrating the efficacy of PrEP, and the dissemination of guidelines endorsing its use, there is a renewed focus on bio-behavioral prevention. Numerous studies have recently assessed the acceptability of bio-behavioral prevention programs among diverse populations or described experiences implementing these programs in “real-world” settings. As research and clinical data informing optimal utilization of PEP and PrEP are rapidly accumulating, this review provides a timely summary of recent progress in bio-behavioral prevention. By contextualizing the most noteworthy recent findings regarding PEP and PrEP, this review seeks to inform the successful implementation of these promising prevention approaches.

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Conflict of Interest

Douglas Krakower reports grants from the National Institutes of Health (K23 MH098795), Gilead Sciences, Bristol Myers Squibb, and personal fees from Medscape.

Kenneth Mayer reports unrestricted research grants from Merck, Gilead, and Bristol Myers Squibb, funding from the Harvard University Center for AIDS Research (CFAR), and an NIH-funded program (P30 AI060354; PI: Walker).

Sachin Jain declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Douglas S. Krakower & Kenneth H. Mayer

  2. The Fenway Institute, Fenway Health, Boston, MA, USA

    Douglas S. Krakower & Kenneth H. Mayer

  3. Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Sachin Jain

  4. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis Street, Suite GB, Boston, MA, 02215-5501, USA

    Douglas S. Krakower

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  1. Douglas S. Krakower
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  2. Sachin Jain
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  3. Kenneth H. Mayer
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Correspondence to Douglas S. Krakower.

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This article is part of the Topical Collection on The Science of Prevention

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Krakower, D.S., Jain, S. & Mayer, K.H. Antiretrovirals for Primary HIV Prevention: the Current Status of Pre- and Post-exposure Prophylaxis. Curr HIV/AIDS Rep 12, 127–138 (2015). https://doi.org/10.1007/s11904-014-0253-5

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