دورية أكاديمية
Update on HIV Preexposure Prophylaxis: Effectiveness, Drug Resistance, and Risk Compensation.
العنوان: | Update on HIV Preexposure Prophylaxis: Effectiveness, Drug Resistance, and Risk Compensation. |
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المؤلفون: | Powell VE; Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA., Gibas KM; Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA., DuBow J; Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA., Krakower DS; Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA. dkrakowe@bidmc.harvard.edu.; The Fenway Institute, Fenway Health, Boston, MA, USA. dkrakowe@bidmc.harvard.edu.; Department of Population Medicine, Harvard Medical School, Boston, MA, USA. dkrakowe@bidmc.harvard.edu. |
المصدر: | Current infectious disease reports [Curr Infect Dis Rep] 2019 Jun 21; Vol. 21 (8), pp. 28. Date of Electronic Publication: 2019 Jun 21. |
نوع المنشور: | Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: Springer US Country of Publication: United States NLM ID: 100888983 Publication Model: Electronic Cited Medium: Print ISSN: 1523-3847 (Print) Linking ISSN: 15233847 NLM ISO Abbreviation: Curr Infect Dis Rep Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Publication: [New York] : Springer US Original Publication: Philadelphia, PA : Current Science, c1999- |
مستخلص: | Purpose of Review: In 2019, the US government launched an initiative to decrease new HIV infections by 90% over the next decade. Studies have demonstrated the efficacy of HIV preexposure prophylaxis (PrEP) for high-risk populations, and the United States Preventative Services Task Force has issued a grade A recommendation for PrEP, indicating substantial net benefit. However, questions have been raised about the effectiveness of PrEP in clinical settings and whether PrEP use might promote antiretroviral drug resistance and increased sexual risk behaviors, which could increase transmission of bacterial sexually transmitted infections. In this narrative review, we summarize recent evidence of the effectiveness of PrEP when provided in clinical and community settings, the emergence of antiretroviral drug resistance during PrEP use, and associations between PrEP use and increased sexual risk behaviors. We also review novel PrEP modalities that are being developed to optimize PrEP acceptability, adherence, and effectiveness. Recent Findings: Studies suggest that PrEP is effective when provided in clinical settings. However, PrEP uptake and impact have been limited in the USA thus far, and major disparities in access to PrEP exist. In addition, there is evidence that drug resistance can occur with PrEP use, particularly with inadvertent PrEP use during undiagnosed acute HIV infection. Risk compensation can also occur with PrEP use and has been associated with increased sexually transmitted infections. Promising new modalities for PrEP could expand options. PrEP has strong potential to decrease HIV incidence. However, disparities in access must be addressed to ensure equity and impact for PrEP. While drug resistance and risk compensation can occur with PrEP use, these are not valid reasons to withhold PrEP from patients given its substantial protective benefits. |
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معلومات مُعتمدة: | P30 AI060354 United States AI NIAID NIH HHS; P30 AI060354 United States NH NIH HHS |
فهرسة مساهمة: | Keywords: Clinical effectiveness; Drug resistance; HIV; Preexposure prophylaxis; Risk compensation |
تواريخ الأحداث: | Date Created: 20190623 Latest Revision: 20211203 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC8635937 |
DOI: | 10.1007/s11908-019-0685-6 |
PMID: | 31227999 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1523-3847 |
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DOI: | 10.1007/s11908-019-0685-6 |