Preexposure Prophylaxis (PrEP) for HIV Prevention: The Primary Care Perspective

Journal of the American Board of Family Medicine : JABFM
James Conniff, Ann Evensen

Abstract

Until recently there have been few primary care office-based strategies to reduce the transmission of HIV. In May 2014 the Centers for Disease Control and Prevention published updated practice guidelines recommending the use of preexposure prophylaxis (PrEP) with daily oral dosing of tenofovir/emtricitabine to help prevent HIV infection in high-risk individuals (strength of recommendation, A). Knowledge of PrEP among primary care providers is low, however, and this intervention is likely reaching only a small fraction of eligible patients. PrEP is recommended for certain injection drug users, nonmonogamous men who have sex with men, heterosexual women who have sex with men who have sex with men or injection drug users, and those in HIV serodiscordant relationships. Providers should obtain baseline laboratory values and provide initial counseling before prescribing PrEP. Regular office visits are necessary to ensure adherence, provide ongoing counseling, and monitor for side effects, including nausea, abdominal pain, headache, and, less commonly, increased creatinine. Guidelines and toolkits have been developed to assist in incorporating PrEP into primary care practice. PrEP is gaining widespread acceptance and has become a cruc...Continue Reading

Citations

Oct 27, 2017·Current HIV/AIDS Reports·Iryna B Zablotska, Catherine C O'Connor
Nov 6, 2018·Sexual Health·Thijs ReyniersChristiana Nöstlinger
Jul 17, 2019·Drugs·Ioannis Hodges-MameletzisRachel Baggaley
Sep 14, 2017·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Helen L ZhangMehri S McKellar
Jan 23, 2018·Health Education & Behavior : the Official Publication of the Society for Public Health Education·Leah M AdamsBruce J Packett
Feb 23, 2020·Journal of General Internal Medicine·Samuel R BuntingTimothy J Keyes
Jul 8, 2018·Canadian Journal of Public Health = Revue Canadienne De Santé Publique·Jeffrey MorganMark Hull

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