PrEP: A Powerful Prevention Tool

Yesterday, the Centers for Disease Control and Prevention (CDC) released its 2015 HIV Vital Signs focusing on preexposure prophylaxis (PrEP). This Vital Signs includes two Morbidity and Mortality Weekly Reports (MMWR), one from CDC and one from New York State Department of Health:Vital Signs: Estimated Percentages and Numbers of Adults with Indications for Preexposure Prophylaxis to Prevent HIV Acquisition — United States, 2015Vital Signs: Increased Medicaid Prescriptions for Preexposure Prophylaxis Against HIV Infection — New York, 2012–2015The report highlights PrEP as an essential component in accelerating progress in HIV prevention. A fact sheet, Daily Pill Can Prevent HIV: Reaching people who could benefit from PrEP, also released yesterday, provides easy access to basic information.

The CDC MMWR estimates the proportion of Americans who are at substantial risk of HIV and should be counseled about PrEP. These include about 25 percent of sexually active gay and bisexual adult men, nearly 20 percent of adults who inject drugs, and less than 1 percent of heterosexually active adults. The report notes that more providers should be aware of PrEP, citing a study that reveals that one-third of primary health care providers had never heard of PrEP.

The New York State Department of Health MMWR suggests that focused efforts can substantially expand the reach of PrEP. Researchers report that PrEP use among New Yorkers covered by Medicaid increased in the year following the launch of a statewide effort that included training providers, raising awareness, and ensuring Medicaid coverage.

PrEP is a powerful prevention tool with the potential to benefit Americans who are most at risk for acquiring HIV. But it is not the only option. Additional high-impact HIV prevention strategies include antiretroviral treatment for people living with HIV; correct and consistent use of condoms; interventions to engage and retain people in care and reduce risk behaviors; and access to drug treatment programs and sterile injection equipment for people who inject drugs. With about 40,000 HIV infections diagnosed every year, we must make the most of all available HIV prevention opportunities for those most at risk.

To accomplish these objectives, we need collaborative action. Providers play a central role in increasing awareness and uptake of PrEP. They can discuss risk and prevention options with their patients, and follow the 2014 US Public Health Service Clinical Practice Guidelines to prescribe PrEP to patients who can benefit from it. Medical and professional associations can also help educate providers and share lessons learned from PrEP implementation efforts. State and local health departments and community-based organizations can integrate PrEP education into their programs.

We encourage you to visit the Vital Signs web site, download materials, and share them with your colleagues.