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?
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.
FROM NEJM — Recent Infectious Disease Articles- Ensitrelvir for Covid-19 Postexposure Prophylaxis in Household Contacts May 14, 2026In a trial, the 3C-like protease inhibitor ensitrelvir was more effective than placebo in preventing Covid-19 in household contacts of patients with SARS-CoV-2 infection.
- Cerebral Syphilitic Gumma May 14, 2026A 50-year-old man presented to the ED with a 1-month history of headache and worsening weakness of the left arm and leg. Brain MRI showed an enhancing lesion with extensive surrounding edema.
- Getting Serious about Tickborne Diseases — Shifting Research Priorities May 13, 2026Research on Lyme disease has emphasized clinical disease and pathogen microbiology rather than the root cause: the infected tick vectors in the environment, which remain uncontrolled.
- Human Infection with Highly Pathogenic Avian Influenza A(H5N5) Virus May 7, 2026Avian influenza can jump species from birds to humans, a fact that arouses concern for serious illness and broader human transmission. In this report, avian influenza A(H5N5) was shown to cause severe human illness.
- Reducing Bacterial Contamination of Blood Bags with a Double Knot May 7, 2026In a study involving 180 blood bags, use of a double-knot closure rather than the usual single knot prevented bacterial contamination. This strategy may reduce the risk of blood-product contamination in resource-limited settings.
- Ensitrelvir for Covid-19 Postexposure Prophylaxis in Household Contacts May 14, 2026
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.