An ongoing dialogue on HIV/AIDS, infectious diseases,
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?
Categories: Antiretroviral Rounds, HIV, Patient Care, Policy
Tags: HIV, pre-exposure prophylaxis, PrEP, TDF/FTC, tenofovir, Truvada
You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
One Response to “Like It or Not, PrEP Enters the Clinic”

Paul E. Sax, MD
Associate Editor
NEJM Clinician
Biography | Disclosures & Summaries
Learn more about HIV and ID Observations.
Search this Blog
Follow HIV and ID Observations Posts via Email
Archives
Most Popular Posts
-
From the Blog — Most Recent Articles
- Florida Moves to Cut AIDS Drug Assistance Program — and Drops the Most Prescribed HIV Regimen in the Country January 27, 2026
- Rabies Is Terrifying — and the Challenge of Managing a Low Risk of a Dreadful Disease January 21, 2026
- Influenza — So Familiar, Still So Mysterious January 14, 2026
- How the Z-Pak Took Over Outpatient Medicine, Part 2: The Reckoning January 6, 2026
- How the Z-Pak Took Over Outpatient Medicine December 29, 2025
FROM NEJM — Recent Infectious Disease Articles- The Essential Role of States in Protecting Immunization Access January 29, 2026In the face of U.S. federal policy shifts that threaten to destabilize vaccine access and weaken clinical guidance, states can step in and protect their residents.
- Case 4-2026: An 80-Year-Old Woman with Cough and Hypoxemia January 29, 2026An 80-year-old woman was admitted to the hospital because of cough and hypoxemia (oxygen saturation, 83%). CT of the chest showed diffuse ground-glass opacities in both lungs. A diagnosis was made.
- A New Therapeutic Broadcast on Hepatitis D, a Satellite Virus January 22, 2026Hepatitis D virus (HDV) is known as a satellite virus because it requires the hepatitis B virus (HBV) surface antigen (HBsAg) to enter the hepatocytes and to complete its life cycle. HDV is the smallest human pathogen, with a single-stranded RNA genome that is approximately 1.7 kb long. Yet, chronic...
- Pneumocystis jirovecii Pneumonia January 22, 2026A 60-year-old man with recently diagnosed HIV infection presented with a 10-day history of fever, dry cough, and shortness of breath. A CT scan of the chest showed diffuse nodules and ground-glass opacities.
- Case 3-2026: A 58-Year-Old Woman with Diplopia and Fever January 22, 2026A 58-year-old woman was admitted to the hospital 3 weeks after lumbar surgery because of diplopia and fever. Left leg pain and a rash had preceded the fever and diplopia. A diagnosis was made.
- The Essential Role of States in Protecting Immunization Access January 29, 2026
-
Tag Cloud
- Abacavir AIDS antibiotics antiretroviral therapy ART atazanavir baseball Brush with Greatness CDC C diff COVID-19 CROI darunavir dolutegravir elvitegravir etravirine FDA HCV hepatitis C HIV HIV cure HIV testing ID fellowship ID Learning Unit Infectious Diseases influenza Link-o-Rama lyme disease medical education MRSA PEP PrEP prevention primary care raltegravir Really Rapid Review resistance Retrovirus Conference rilpivirine sofosbuvir TDF/FTC tenofovir Thanksgiving vaccines zoster

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.
http://www.ghdonline.org/hivprevention/discussion/march-7-11-ghdonline-to-host-virtual-panel-discuss/
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.
Panelists:
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.