Study: PrEP Awareness and Use Is Increasing

Pre-exposure prophylaxis (PrEP) can reduce the risk of HIV infection in individuals at high risk. If PrEP is taken daily consistently, it can reduce the risk of HIV by up to 92%.¹ CDC guidelines recommend the fixed-dose combination of tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg (Truvada, Gilead) daily for sexually-active adult men who have sex with men (MSM) at substantial risk of contracting HIV.²

A recent study looked at data from the CDC’s National HIV Behavioral Surveillance (NHBS) collected in 20 urban areas in the United States, in 2014 and 2017, examining 26 of the geographic areas included in Phase I of the Ending the HIV Epidemic initiative.³ Changes in PrEP awareness and use among MSM were evaluated from 2014-2017.³ Cross-sectional behavioral survey data through a questionnaire was collected, and anonymous HIV testing was conducted.³ Study participants were limited to MSM who had a negative NHBS HIV test result, did not report a previous HIV-positive test result, had either 1 male sex partner who was HIV-positive or 2 or more male sex partners in the past 12 months, and reported either condomless anal sex or a bacterial sexually transmitted infection (e.g. syphilis, gonorrhea, or chlamydia) in the past 12 months.³

The study revealed that from 2014-2017, PrEP awareness increased from 60% to 90% among MSM.³ Also, PrEP use increased from 6% to 35%, but this is still considered low especially among black and Hispanic MSM. This study revealed important information about the increased awareness and use of PrEP among MSM and can be used for future research. However, some limitations include that surveys examine a snapshot in time with self-reporting and do not include long-term monitoring. Also, NHBS uses a 12-month timeframe to assess risk behaviors, whereas the guidelines follow a 6-month period.³

More efforts are crucial to reach the goal of 90% reduction in HIV incidence by 2030.³ Pharmacists can play an important role as part of an interdisciplinary team to test for HIV, assess patient risk, recommend PrEP, and monitor patients (every 3 months).

Pharmacists can also educate their colleagues and other clinicians that the FDA approved an indication in May 2018 for TDF/FTC for PrEP use in adolescents, which will be added to the upcoming guidelines.¹ As the use of PrEP is expanded, future studies should be conducted on awareness and efficacy.

References

• Pre-exposure prophylaxis (PrEP). CDC website. https://www.cdc.gov/hiv/risk/prep/. Last updated May 28, 2019. Accessed July 12, 2019.
• CDC. US Public Health Service: preexposure prophylaxis for the prevention of HIV infection in the United States-2017 update: a clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf. Accessed July 12, 2019.
• Finlayson T, Cha S, Xia M, et al. Changes in HIV Preexposure Prophylaxis Awareness and Use Among Men Who Have Sex with Men — 20 Urban Areas, 2014 and 2017. MMWR Morb Mortal Wkly Rep 2019;68:597-603. DOI: http://dx.doi.org/10.15585/mmwr.mm6827a1.