Daily Pre-Exposure Prophylaxis for HIV Indicated for Over 1.2 Million Americans

Published by NEJM Journal Watch, November 25, 2015

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Roughly a quarter of men who have sex with men (MSM) should receive daily pre-exposure prophylaxis (PrEP) to lower their risk for HIV acquisition, according to a CDC analysis in Vital Signs.

Examining national survey data, researchers found that 25% of MSM without known HIV reported having sex with at least two men in the prior year and having condomless sex or a sexually transmitted infection — thereby meeting behavioral criteria for daily PrEP, according to the CDC's 2014 guidelines. In addition, 19% of adult injection-drug users without HIV reported using a needle that had already been used by another person — making them candidates for daily PrEP. Lastly, 0.4% of heterosexually active, HIV-negative adults should receive PrEP, based on high-risk behaviors such as sex with an HIV-infected person.

The researchers estimate that overall, more than 1.2 million U.S. adults have indications for PrEP. They call for "efforts to increase knowledge of and access" to such treatment.

Eamonn Vitt