Skip to main content

Advertisement

SpringerLink
Log in

Update on HIV Preexposure Prophylaxis: Effectiveness, Drug Resistance, and Risk Compensation

  • HIV/AIDs (C Yoon, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

Abstract

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.

Summary

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. HIV in the United States: at a glance. 2017. https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Accessed May 20, 2019.

  2. U.S. Department of Health & Human Services. Ending the HIV Epidemic. 2019. https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview. Accessed May 20, 2019.

  3. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

  4. Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083–90.

    Article  PubMed  Google Scholar 

  5. Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.

    Article  CAS  PubMed  Google Scholar 

  6. Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Smith DK, Van Handel M, Grey J. Estimates of adults with indications for HIV pre-exposure prophylaxis by jurisdiction, transmission risk group, and race/ethnicity, United States, 2015. Annals of Epidemiology. 2018;28(12):850–7. e9.

    Article  PubMed  Google Scholar 

  8. Huang Y-lA, Zhu W, Smith DK, Harris N, Hoover KW. HIV preexposure prophylaxis, by race and ethnicity—United States, 2014–2016. Morb Mortal Wkly Rep. 2018;67(41):1147–50.

    Article  Google Scholar 

  9. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States—2017 Update: a clinical practice guideline. Atlanta: CDC. 2018.

  10. U.S. Department of Health and Human Services. FDA approves first drug for reducing the risk of sexually acquired HIV infection. 2012. https://aidsinfo.nih.gov/news/1254/fda-approves-first-drug-for-reducing-the-risk-of-sexually-acquired-hiv-infection. Accessed May 20, 2019.

  11. Marcus JL, Hurley LB, Hare CB, Nguyen DP, Phengrasamy T, Silverberg MJ, et al. Preexposure prophylaxis for HIV prevention in a large integrated health care system: adherence, renal safety, and discontinuation. J Acquir Immune Defic Syndr (1999). 2016;73(5):540–6.

    Article  Google Scholar 

  12. Montgomery MC, Oldenburg CE, Nunn AS, Mena L, Anderson P, Liegler T, et al. Adherence to pre-exposure prophylaxis for HIV prevention in a clinical setting. PLoS One. 2016;11(6):e0157742.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Mayer KH, Krakower D, Grasso C, Levine K, Powell V, Campbell J et al., editors. Decreased HIV incidence among PrEP users compared to non-users in a Boston community health center, 2012-2017. HIV research for prevention conference; 2018.

  14. Grulich AE, Guy R, Amin J, Jin F, Selvey C, Holden J, et al. Population-level effectiveness of rapid, targeted, high-coverage roll-out of HIV pre-exposure prophylaxis in men who have sex with men: the EPIC-NSW prospective cohort study. The Lancet HIV. 2018;5(11):e629–37.

    Article  PubMed  Google Scholar 

  15. Deutsch MB, Glidden DV, Sevelius J, Keatley J, McMahan V, Guanira J, et al. HIV pre-exposure prophylaxis in transgender women: a subgroup analysis of the iPrEx trial. The Lancet HIV. 2015;2(12):e512–e9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hanscom B, Janes HE, Guarino PD, Huang Y, Brown ER, Chen YQ, et al. Preventing HIV-1 infection in women using oral pre-exposure prophylaxis: a meta-analysis of current evidence. J Acquir Immune Defic Syndr (1999). 2016;73(5):606–8.

    Article  Google Scholar 

  17. Cottrell ML, Yang KH, Prince HM, Sykes C, White N, Malone S, et al. A translational pharmacology approach to predicting outcomes of preexposure prophylaxis against HIV in men and women using tenofovir disoproxil fumarate with or without emtricitabine. J Infect Dis. 2016;214(1):55–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wahl A, Ho PT, Denton PW, Garrett KL, Hudgens MG, Swartz G, et al. Predicting HIV pre-exposure prophylaxis efficacy for women using a preclinical pharmacokinetic-pharmacodynamic in vivo model. Sci Rep. 2017;7:41098.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Patterson KB, Prince HA, Kraft E, Jenkins AJ, Shaheen NJ, Rooney JF, et al. Penetration of tenofovir and emtricitabine in mucosal tissues: implications for prevention of HIV-1 transmission. Sci Transl Med. 2011;3(112):112re4–4.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Seifert SM, Chen X, Meditz AL, Castillo-Mancilla JR, Gardner EM, Predhomme JA, et al. Intracellular tenofovir and emtricitabine anabolites in genital, rectal, and blood compartments from first dose to steady state. AIDS Res Hum Retrovir. 2016;32(10–11):981–91.

    Article  CAS  PubMed  Google Scholar 

  21. Louissaint NA, Cao Y-J, Skipper PL, Liberman RG, Tannenbaum SR, Nimmagadda S, et al. Single dose pharmacokinetics of oral tenofovir in plasma, peripheral blood mononuclear cells, colonic tissue, and vaginal tissue. AIDS Res Hum Retrovir. 2013;29(11):1443–50.

    Article  CAS  PubMed  Google Scholar 

  22. Velloza J, Heffron R. The vaginal microbiome and its potential to impact efficacy of HIV pre-exposure prophylaxis for women. Current HIV/AIDS Reports. 2017;14(5):153–60.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Heffron R, McClelland RS, Balkus JE, Celum C, Cohen CR, Mugo N, et al. Efficacy of oral pre-exposure prophylaxis (PrEP) for HIV among women with abnormal vaginal microbiota: a post-hoc analysis of the randomised, placebo-controlled Partners PrEP Study. The Lancet HIV. 2017;4(10):e449–e56.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Eastment MC, McClelland RS. Vaginal microbiota and susceptibility to HIV. AIDS (London, England). 2018;32(6):687–98.

    Article  Google Scholar 

  25. McKinnon LR, Liebenberg LJ, Yende-Zuma N, Archary D, Ngcapu S, Sivro A, et al. Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women. Nat Med. 2018;24(4):491–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Cottrell ML, Prince H, Schauer AP, Sykes C, Maffuid K, Poliseno A et al. Decreased tenofovir diphosphate concentrations in a transgender female cohort: implications for HIV pre-exposure prophylaxis (PrEP). Clinical Infectious Diseases. 2019 [Accepted Manuscript].

    Google Scholar 

  27. Snowden JM, Chen Y-H, McFarland W, Raymond HF. Prevalence and characteristics of users of pre-exposure prophylaxis (PrEP) among men who have sex with men, San Francisco, 2014 in a cross-sectional survey: implications for disparities. Sex Transm Infect. 2017;93(1):52–5.

    Article  PubMed  Google Scholar 

  28. Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G, Group NHBSS, Wortley P et al. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men—20 US cities, 2014. Clin Infect Dis 2016;63(5):672–677.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Centers for Disease Control and Prevention. HIV among women. 2017. https://www.cdc.gov/hiv/group/gender/women/index.html. Accessed May 20, 2019.

  30. Centers for Disease Control and Prevention. HIV among people who inject drugs. 2016. https://www.cdc.gov/hiv/group/hiv-idu.html. Accessed May 20, 2019.

  31. Arrington-Sanders R, Morgan A, Oidtman J, Qian I, Celentano D, Beyrer C. A medical care missed opportunity: preexposure prophylaxis and young black men who have sex with men. J Adolesc Health. 2016;59(6):725–8.

    Article  PubMed  Google Scholar 

  32. Philbin MM, Parker CM, Parker RG, Wilson PA, Garcia J, Hirsch JS. The promise of pre-exposure prophylaxis for black men who have sex with men: an ecological approach to attitudes, beliefs, and barriers. AIDS Patient Care STDs. 2016;30(6):282–90.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Hubach RD, Currin JM, Sanders CA, Durham AR, Kavanaugh KE, Wheeler DL, et al. Barriers to access and adoption of pre-exposure prophylaxis for the prevention of HIV among men who have sex with men (MSM) in a relatively rural state. AIDS Educ Prev. 2017;29(4):315–29.

    Article  PubMed  Google Scholar 

  35. Morgan J, Ferlatte O, Salway T, Wilton J, Hull M. Awareness of, interest in, and willingness to pay for HIV pre-exposure prophylaxis among Canadian gay, bisexual, and other men who have sex with men. Can J Public Health. 2018;109(5–6):791–9.

    Article  PubMed  Google Scholar 

  36. Marcus JL, Hurley LB, Dentoni-Lasofsky D, Ellis CG, Silverberg MJ, Slome S, et al. Barriers to preexposure prophylaxis use among individuals with recently acquired HIV infection in Northern California. AIDS Care. 2019;31(5):536–44.

    Article  PubMed  Google Scholar 

  37. Pérez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: the P18 study. AIDS Educ Prev. 2015;27(2):112–25.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Rana J, Wilton J, Fowler S, Hart TA, Bayoumi AM, Tan DH. Trends in the awareness, acceptability, and usage of HIV pre-exposure prophylaxis among at-risk men who have sex with men in Toronto. Can J Public Health. 2018;109:342–52.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Krakower DS, Mayer KH. The role of healthcare providers in the roll-out of PrEP. Curr Opin HIV AIDS. 2016;11(1):41–8.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Blumenthal J, Jain S, Krakower D, Sun X, Young J, Mayer K, et al. Knowledge is power! Increased provider knowledge scores regarding pre-exposure prophylaxis (PrEP) are associated with higher rates of PrEP prescription and future intent to prescribe PrEP. AIDS Behav. 2015;19(5):802–10.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Wood BR, McMahan VM, Naismith K, Stockton JB, Delaney LA, Stekler JD. Knowledge, practices, and barriers to HIV preexposure prophylaxis prescribing among Washington state medical providers. Sex Transm Dis. 2018;45(7):452–8.

    Article  PubMed  Google Scholar 

  42. Petroll AE, Walsh JL, Owczarzak JL, McAuliffe TL, Bogart LM, Kelly JA. PrEP awareness, familiarity, comfort, and prescribing experience among US primary care providers and HIV specialists. AIDS Behav. 2017;21(5):1256–67.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Zablotska IB, O’Connor CC. Preexposure prophylaxis of HIV infection: the role of clinical practices in ending the HIV epidemic. Current HIV/AIDS Reports. 2017;14(6):201–10.

    Article  PubMed  Google Scholar 

  44. Patel RR, Chan PA, Harrison LC, Mayer KH, Nunn A, Mena LA, et al. Missed opportunities to prescribe HIV pre-exposure prophylaxis by primary care providers in Saint Louis, Missouri. LGBT health. 2018;5(4):250–6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Krakower D, Ware N, Mitty JA, Maloney K, Mayer KH. HIV providers’ perceived barriers and facilitators to implementing pre-exposure prophylaxis in care settings: a qualitative study. AIDS Behav. 2014;18(9):1712–21.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Ojile N, Sweet D, Kallail KJ. A preliminary study of the attitudes and barriers of family physicians to prescribing HIV preexposure prophylaxis. Kans J Med. 2017;10(2):40–2.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Clement ME, Seidelman J, Wu J, Alexis K, McGee K, Okeke NL, et al. An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern US. AIDS Care. 2018;30(5):650–5.

    Article  PubMed  Google Scholar 

  48. Ard KL, Edelstein ZR, Bolduc P, Daskalakis D, Gandhi AD, Krakower DS, et al. Public health detailing for human immunodeficiency virus pre-exposure prophylaxis. Clin Infect Dis. 2018;68(5):860–4.

    Article  Google Scholar 

  49. Krakower D, Gruber S, Hsu K, Menchaca J, Maro J, Kruskal B, et al. Development and validation of an automated HIV prediction algorithm to identify candidates for pre-exposure prophylaxis: a modelling study. The Lancet HIV. In press.

  50. Marcus J, Hurley L, Krakower D, Alexeeff S, Silverberg M, Volk J. Use of electronic health record data and machine learning to identify candidates for HIV pre-exposure prophylaxis: a modelling study. The Lancet HIV. In press.

  51. Krakower D, Powell VE, Maloney K, Wong JB, Wilson IB, Mayer K. Impact of a personalized clinical decision aid on informed decision-making about HIV preexposure prophylaxis among men who have sex with men. In: International conference on HIV treatment and prevention adherence; 2018.

    Google Scholar 

  52. Powell VE, Mayer K, MAloney KM, Wong JB, Wilson IB, Krakower DS. Impact of a clinical decision aid for prescribing HIV preexposure prophylaxis to men who have sex with men on primary care provider knowledge and intentions. In: International conference on HIV treatment and prevention adherence; 2018.

    Google Scholar 

  53. Hojilla JC, Vlahov D, Crouch P-C, Dawson-Rose C, Freeborn K, Carrico A. HIV pre-exposure prophylaxis (PrEP) uptake and retention among men who have sex with men in a community-based sexual health clinic. AIDS Behav. 2018;22(4):1096–9.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Siegler AJ, Mouhanna F, Giler RM, Weiss K, Pembleton E, Guest J, et al. The prevalence of pre-exposure prophylaxis use and the pre-exposure prophylaxis–to-need ratio in the fourth quarter of 2017, United States. Ann Epidemiol. 2018;28(12):841–9.

    Article  PubMed  Google Scholar 

  55. Gibas KM, van den Berg P, Powell VE, Krakower DS. Drug resistance during HIV pre-exposure prophylaxis. Drugs. 2019;79(6):609–19.

    Article  CAS  PubMed  Google Scholar 

  56. Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O’reilly KR, Koechlin FM, et al. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS (London, England). 2016;30(12):1973–83.

    Article  Google Scholar 

  57. Krakower D, Maloney KM, Powell VE, Levine K, Grasso C, Melbourne K, et al. Patterns and clinical consequences of discontinuing HIV preexposure prophylaxis during primary care. J Int AIDS Soc. 2019;22(2):e25250.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Misra K, Huang J, Daskalakis DC, Udeagu C-C. Impact of PrEP on drug resistance and acute HIV infection. In: Conference on retroviruses and opportunistic infections. New York City; 2015-2017. p. 2019.

  59. Knox DC, Anderson PL, Harrigan PR, Tan DH. Multidrug-resistant HIV-1 infection despite preexposure prophylaxis. N Engl J Med. 2017;376(5):501–2.

    Article  PubMed  Google Scholar 

  60. Colby DJ, Kroon E, Sacdalan C, Gandhi M, Grant RM, Phanuphak P, et al. Acquisition of multidrug-resistant human immunodeficiency virus type 1 infection in a patient taking preexposure prophylaxis. Clin Infect Dis. 2018;67(6):962–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Thaden JT, Gandhi M, Okochi H, Hurt CB, McKellar MS. Seroconversion on preexposure prophylaxis: a case report with segmental hair analysis for timed adherence determination. AIDS. 2018;32(9):F1–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Markowitz M, Grossman H, Anderson PL, Grant R, Gandhi M, Horng H, et al. Newly acquired infection with multidrug-resistant HIV-1 in a patient adherent to preexposure prophylaxis. J Acquir Immune Defic Syndr. 2017;76(4):e104–e6.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Cohen SE, Sachdev D, Lee SA, Scheer S, Bacon O, Chen M-J, et al. Acquisition of tenofovir-susceptible, emtricitabine-resistant HIV despite high adherence to daily pre-exposure prophylaxis: a case report. The Lancet HIV. 2019;6(1):e43–50.

    Article  Google Scholar 

  64. Hoornenborg E, Prins M, Achterbergh RC, Woittiez LR, Cornelissen M, Jurriaans S, et al. Acquisition of wild-type HIV-1 infection in a patient on pre-exposure prophylaxis with high intracellular concentrations of tenofovir diphosphate: a case report. The Lancet HIV. 2017;4(11):e522–e8.

    Article  PubMed  Google Scholar 

  65. Braxton J, Davis DW, Emerson B, Flagg EW, Grey J, Grier L et al. Sexually transmitted disease surveillance 2017: Centers for Disease Control and Prevention. 2018.

    Book  Google Scholar 

  66. Calabrese SK, Magnus M, Mayer KH, Krakower DS, Eldahan AI, Hawkins LAG, et al. “Support Your Client at the Space That They’re in”: HIV pre-exposure prophylaxis (PrEP) prescribers’ perspectives on PrEP-related risk compensation. AIDS Patient Care STDs. 2017;31(4):196–204.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Cassell MM, Halperin DT, Shelton JD, Stanton D. Risk compensation: the Achilles’ heel of innovations in HIV prevention? Br Med J. 2006;332(7541):605–7.

    Article  Google Scholar 

  68. Crepaz N, Hart TA, Marks G. Highly active antiretroviral therapy and sexual risk behavior: a meta-analytic review. JAMA. 2004;292(2):224–36.

    Article  CAS  PubMed  Google Scholar 

  69. Martin JN, Roland ME, Neilands TB, Krone MR, Bamberger JD, Kohn RP, et al. Use of postexposure prophylaxis against HIV infection following sexual exposure does not lead to increases in high-risk behavior. AIDS. 2004;18(5):787–92.

    Article  PubMed  Google Scholar 

  70. Marcus JL, Glidden DV, Mayer KH, Liu AY, Buchbinder SP, Amico KR, et al. No evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLoS One. 2013;8(12):e81997.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  71. Doblecki-Lewis S, Cohen S, Liu A. Clinical treatment options infectious diseases: update on PrEP implementation, adherence, and advances in delivery. Current Treatment Options in Infectious Diseases. 2015;7(2):101–12.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Newcomb ME, Moran K, Feinstein BA, Forscher E, Mustanski B. Pre-exposure prophylaxis (PrEP) use and condomless anal sex: evidence of risk compensation in a cohort of young men who have sex with men. J Acquir Immune Defic Syndr. 2018;77(4):358–64.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Hoornenborg E, Coyer L, van Laarhoven A, Achterbergh R, de Vries H, Prins M, et al. Change in sexual risk behaviour after 6 months of pre-exposure prophylaxis use: results from the Amsterdam pre-exposure prophylaxis demonstration project. AIDS. 2018;32(11):1527–32.

    Article  PubMed  Google Scholar 

  74. Oldenburg CE, Nunn AS, Montgomery M, Almonte A, Mena L, Patel RR, et al. Behavioral changes following uptake of HIV pre-exposure prophylaxis among men who have sex with men in a clinical setting. AIDS Behav. 2018;22(4):1075–9.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Volk JE, Marcus JL, Phengrasamy T, Blechinger D, Nguyen DP, Follansbee S, et al. No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis. 2015;61(10):1601–3.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Nguyen V-K, Greenwald ZR, Trottier H, Cadieux M, Goyette A, Beauchemin M, et al. Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV. AIDS (London, England). 2018;32(4):523.

    Google Scholar 

  77. Traeger MW, Cornelisse VJ, Asselin J, Price B, Roth NJ, Willcox J, et al. Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection. JAMA. 2019;321(14):1380–90.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Traeger MW, Schroeder SE, Wright EJ, Hellard ME, Cornelisse VJ, Doyle JS, et al. Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis. Clin Infect Dis. 2018;67(5):676–86.

    Article  PubMed  Google Scholar 

  79. Price JC, McKinney JE, Crouch P-C, Dillon SM, Radix A, Stivala A, et al. Sexually acquired hepatitis C infection in HIV-uninfected men who have sex with men using preexposure prophylaxis against HIV. J Infect Dis. 2018;40:1–4.

    Google Scholar 

  80. Paz-Bailey G, Mendoza MC, Finlayson T, Wejnert C, Le B, Rose C, et al. Trends in condom use among MSM in the United States: the role of antiretroviral therapy and seroadaptive strategies. AIDS (London, England). 2016;30(12):1985–90.

    Article  Google Scholar 

  81. Molina J-M, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, et al. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373(23):2237–46.

    Article  CAS  PubMed  Google Scholar 

  82. Molina J-M, Charreau I, Spire B, Cotte L, Chas J, Capitant C, et al. Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study. The Lancet HIV. 2017;4(9):e402–e10.

    Article  PubMed  Google Scholar 

  83. Molina J-M, Ghosn J, Béniguel L, Rojas-Castro D, Algarte-Genin M, Pialoux G et al., editors. Incidence of HIV-infection in the ANRS Prévenir study in Paris region with daily or on-demand PrEP with TDF/FTC. International AIDS Conference; 2018.

  84. Reyniers T, Nöstlinger C, Laga M, De Baetselier I, Crucitti T, Wouters K, et al. Choosing between daily and event-driven pre-exposure prophylaxis: results of a Belgian PrEP demonstration project. J Acquir Immune Defic Syndr. 2018;79(2):186–94.

    Article  PubMed  Google Scholar 

  85. Hare CB, Coll J, Ruane P, Molina J-M, Mayer KH, Jessen H et al. The phase 3 DISCOVER study: daily F/TAF or F/TDF for HIV preexposure prophylaxis. Conference on retroviruses and opportunistic infections 2019.

    Google Scholar 

  86. Nel A, van Niekerk N, Kapiga S, Bekker L-G, Gama C, Gill K, et al. Safety and efficacy of a dapivirine vaginal ring for HIV prevention in women. N Engl J Med. 2016;375(22):2133–43.

    Article  CAS  PubMed  Google Scholar 

  87. Baeten JM, Palanee-Phillips T, Brown ER, Schwartz K, Soto-Torres LE, Govender V, et al. Use of a vaginal ring containing dapivirine for HIV-1 prevention in women. N Engl J Med. 2016;375(22):2121–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. International Partnership for Microbicides. IPM’s application for dapivirine vaginal ring for reducing HIV risk in women now under review by European medicines agency. 2017.

  89. Radzio-Basu J, Council O, Cong M-e, Ruone S, Newton A, Wei X, et al. Drug resistance emergence in macaques administered cabotegravir long-acting for pre-exposure prophylaxis during acute SHIV infection. Nat Commun. 2005;2019(10):1.

    Google Scholar 

Download references

Funding

This manuscript was made possible with help from the Harvard University Center for AIDS Research (CFAR), a National Institutes of Health–funded program (P30 AI060354).

Author information

Author notes

  1. Victoria E. Powell and Kevin M. Gibas contributed equally to this work.

Authors and Affiliations

  1. Division of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA

    Victoria E. Powell, Kevin M. Gibas, Joshua DuBow & Douglas S. Krakower

  2. The Fenway Institute, Fenway Health, Boston, MA, USA

    Douglas S. Krakower

  3. Department of Population Medicine, Harvard Medical School, Boston, MA, USA

    Douglas S. Krakower

Authors
  1. Victoria E. Powell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kevin M. Gibas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joshua DuBow
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Douglas S. Krakower
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Douglas S. Krakower.

Ethics declarations

Conflict of Interest

DK has participated in HIV-prevention research supported by a grant from Gilead Sciences to Fenway Health, has received honoraria from Medscape, MED-IQ, and DKBmed for developing continuing medical education content focused on HIV prevention, and has received royalties from UptoDate, Inc. for authoring medical education content on HIV preexposure prophylaxis. VP, KG, and JD declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on HIV/AIDs

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Powell, V.E., Gibas, K.M., DuBow, J. et al. Update on HIV Preexposure Prophylaxis: Effectiveness, Drug Resistance, and Risk Compensation. Curr Infect Dis Rep 21, 28 (2019). https://doi.org/10.1007/s11908-019-0685-6

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11908-019-0685-6

Keywords

Search

Navigation