PREEXPOSURE PROPHYLAXIS FOR HIV PREVENTION

Course overview

PRE-EXPOSURE CHEMOPROPHYLAXIS IS A RELATIVELY NEW CONCEPT THAT CONSISTS OF DAILY INTAKE OF ANTIRETROVIRAL MEDICATIONS THAT PROTECT HIGH-RISK INDIVIDUALS FROM HIV INFECTION. SEVERAL TRIALS HAVE SHOWN THAT WHEN PRE-EXPOSURE CHEMOPROPHYLAXIS IS CLOSELY MONITORED FOR ADHERENCE, IT IS AN EFFECTIVE METHOD TO REDUCE THE RISK OF HIV INFECTION, ALMOST TO ZERO. THIS NEW CONCEPT IS NOW SEEN AS A MORE EFFECTIVE WAY OF PREVENTING HIV INFECTION THAN TREATING THE INDIVIDUAL AFTER EXPOSURE. THE IMPORTANT THING TO NOTE IS THAT PRE-EXPOSURE CHEMOPROPHYLAXIS IS ONLY EFFECTIVE AGAINST HIV AND DOES NOT PROVIDE PROTECTION AGAINST ANY OTHER SEXUALLY TRANSMITTED INFECTION (STI), HEPATITIS, OR BLOOD-BORNE INFECTIONS. THE CRITICAL FEATURE OF THIS REGIMEN IS THAT ADHERENCE TO MEDICATION MUST BE TOTAL. INDIVIDUALS WHO REGULARLY MISS DOSES OF THEIR MEDICATION WILL BE AT HIGH RISK FOR ACQUIRING HIV. THUS, PRE-EXPOSURE CHEMOPROPHYLAXIS FOR HIV PREVENTION IS PART OF A COMBINATION PACKAGE THAT ALSO INCLUDES SUPPORT, SEX EDUCATION, AND ADVICE ABOUT THE IMPORTANCE OF ADHERENCE TO TREATMENT. THIS ACTIVITY REVIEWS THE PROS AND CONS OF PREEXPOSURE PROPHYLAXIS FOR HIV AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN SELECTING THE RIGHT PATIENTS.