Pre-exposure Prophylaxis (PrEP) For Prevention of Human Immunodeficiency Virus: A Primary Practice Approach.

Abstract

Acquired immunodeficiency syndrome (AIDS) is a chronic immune system disease caused by human immunodeficiency virus (HIV), first reported in 1981, and continues to interfere with the body's ability to fight infection and disease. There is no cure for HIV/AIDS, but medication can control infection and prevent disease progression. Pre-exposure prophylaxis (PrEP) taken orally, or as intramuscular injection, is safe and effective in reducing the chances of acquiring HIV. United States Preventive Services Task Force (U.S.P.S.T.F.) and Center of Disease Control and Prevention (CDC) guidelines recommend providing behavioral counseling as well as prescribing PrEP for all sexually active adolescents and adults to decrease risk of HIV acquisition. In light of the United States (U.S.) Department of Health and Human Services (DHHS) goal for ending the HIV epidemic, all healthcare providers should be familiar with recommending PrEP as indicated to aid in disease eradication. The goal is to reduce new HIV infections in the U.S. by 75% in 2025 and 90% in 2030. In 2021, CDC data showed 30% of people who could benefit from PrEP were prescribed medication, an improvement from 13% in 2017. Although progress has been made in preventing and treating HIV, prevention efforts must further improve to reach all populations equitably to achieve a national PrEP coverage goal of 50%, by the end of this year, 2025. In this review, we highlight the urgency for all healthcare providers to offer PrEP to their sexually active patients, we provide the supportive data behind PrEP use, and we guide the clinician through safely ordering and monitoring its use in routine patient care. Continued education for providers and the public will help facilitate early intervention and better management to end the HIV epidemic.