Best Practices: Interventions for PrEP

Content From: Jonathan Mermin, MD, MPH, RADM and Assistant Surgeon General, USPHS, Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, and Demetre Daskalakis, MD, MPH, Director, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention•Published: February 11, 2021•2 min read

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The Centers for Disease Control and Prevention (CDC HIV/AIDS Prevention Research Synthesis (PRS) Project) identifies evidence-based interventions (EBIs) and evidence-informed interventions (EIs) for the Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. The Compendium helps HIV prevention planners and providers in the United States (US) select interventions most appropriate for their communities. The Compendium contains chapters on risk reduction; medication adherence; linkage to, retention in, and re-engagement in HIV care; and structural interventions.

The PRS Project recently added a new chapter to the Compendium. The new Pre-Exposure Prophylaxis (PrEP) Chapter identifies effective interventions for PrEP use and persistence.

Following consultations with CDC and National Institutes of Health (NIH) subject matter experts, two sets of evaluation criteria were developed for the PrEP chapter. Evidence-based criteria evaluate intervention studies that have a comparison group whereas evidence-informed criteria evaluate intervention studies have a pre-post comparison only. Evidence-based criteria provide the strongest evidence of efficacy whereas evidence-informed criteria identify interventions with modest evidence of efficacy.

The EBIs and EIs presented in this chapter are the result of a systematic evaluation of each eligible PrEP intervention study against a priori criteria that includes the risk of bias and strength of findings for each individual study.

Three U.S.-based interventions focused on men who have sex with men (MSM) at risk for HIV acquisition (1 EBI and 2 EIs) have been identified. The EBI, called PrEPmate, used interactive multicomponent mHealth techniques (short message service and youth-tailored interactive online content) to improve retention in PrEP care and PrEP medication adherence/persistence for young MSM at risk for HIV acquisition. EIs include a culturally tailored counseling program to increase PrEP initiation/uptake among high-risk young black MSM (PrEP Counseling Center) and a nurse-delivered individual-level cognitive-behavioral intervention to increase PrEP adherence/persistence among MSM who are at high risk for HIV acquisition (Life-Steps for PrEP) .

All PRS evaluated interventions can be found by using the PRS Compendium Search. For more information on CDC resources for PrEP, please visit effectiveinterventions.cdc.org and https://www.cdc.gov/hiv/risk/prep/.