PrEP for HIV Prevention: A Guideline Update Topline
The CDC update recommends that clinicians advise all sexually active patients about PrEP and includes a new section on prescribing injectable bimonthly cabotegravir.
The Centers for Disease Control and Prevention (CDC) released its Preexposure Prophylaxis for the Prevention of HIV Infection in the United States—2021 Update—A Clinical Practice Guideline in December 2021.
The updates reflect the most recent science and are intended to support clinicians in prescribing all FDA-approved PrEP medications and to increase PrEP use among all those who could benefit.
The most noteworthy new recommendation which applies to all health care providers is to inform all sexually active adults/adolescents about PrEP, an effort to broaden awareness of the treatment option. And, in addition to taking a brief sexual history to identify those with inidications for PrEP, that PrEP be prescribed for anyone who requests it, even if they do not disclose specific risk behaviors. A topline of the guideline updates follows in this short slide show.
Inform all sexually active adults and adolescents that PrEP can protect them from getting HIV.
Offer PrEP to anyone who asks for it, even if they do not report risky behavior.
Prescribe cabotegravir (CAB) injections as PrEP for sexually active adults who would most benefit from the option.
Who shoudl be prescribed PrEP: Assessing risk of sexual HIV acquisition.
Use HIV antigen/antibody tests for patients starting/restarting PrEP and those taking/recently taken PrEP.
When antigen/antibody test is positive, link patient to HIV care; when test is negative, continuing prescribing PrEP.
Oral PrEP update: F/TAF is approved as daily PrEP otpion for sexually active men and transgender women.
TDF: emtricitabine (F)/tenofovir disoproxil fumarate (Truvada)
TAF: emtricitabine (F)/tenofovir alafenamide (Descovy)
For patients taking oral PrEP, CDC revised recommendations for ongoing clinical assessments.
New recommendations included for ongoing clinical assessments of injectable PrEP (IM CAB).
Evolving terminology: Sex, gender identity, sexual orientation
Adapted from GLAAD Media Reference Guide
Evolving terminology: Transgender, cisgender
Evolving terminology: Gender expression, gender non-conforming
Evolving terminology: Nonbinary and/or genderqueer
Reference: Centers for Disease Control and Prevention. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update Clinical Practice Guideline. Atlanta, GA: Centers for Disease Control and Prevention, US Public Health Service; 2021.
