March 1st, 2011

Like It or Not, PrEP Enters the Clinic

Since the publication of iPrEx, the hypothetical decision about whether to prescribe pre-exposure prophylaxis (PrEP) has become a practical reality.

As a result, we’ve posted a case on the Journal Watch/AIDS Clinical Care site, describing someone who requests intermittent pre-exposure prophylaxis to prevent HIV.

It’s a high-risk, HIV-negative man who’s been treated several times with post-exposure prophylaxis. The case was adapted from someone seen recently in our practice, and it raised many questions about what to do in this newly minted area. As there are obviously no “right” answers, we had a broad range of responses within our group. We’ve asked experts in the field to weigh in as well and will publish those responses shortly.

In the meantime, what have you been doing with requests for PrEP?  Have you found the “Guidance” (note that these are not yet “Guidelines”) useful?  Any helpful or just interesting anecdotes or opinions you wish to share?

One Response to “Like It or Not, PrEP Enters the Clinic”

  1. Great discussion points on PrEP. GHDonline is partnering with MGH’s HOPE Conference Serires to host a “virtual discussion” on PrEP in practice next week. Would love for you to jump into the conversation and summarize it here on your blog.

    Panelists from Uganda, South Africa and the United States will add discussions to the online community, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered.

    All GHDonline members can participate in this virtual discussion. Sign up here if you haven’t already joined and keep your email settings to “per post” to track the discussion live in your inbox.


    Douglas Krakower, MD is a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School

    Andrew Mujugira, MBChB, MSc is the East Africa regional medical director for the Partners PrEP study.

    Vivek Naranbhai, PhD, was involved in CAPRISA microbicide gel study.

HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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