{"id":5934,"date":"2015-03-28T19:13:16","date_gmt":"2015-03-28T23:13:16","guid":{"rendered":"http:\/\/blogs.nejm.org\/hiv-id-observations\/?p=5934"},"modified":"2015-03-28T19:13:16","modified_gmt":"2015-03-28T23:13:16","slug":"quick-question-should-hiv-negative-people-in-serodiscordant-relationships-all-get-prep","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/quick-question-should-hiv-negative-people-in-serodiscordant-relationships-all-get-prep\/2015\/03\/28\/","title":{"rendered":"Quick Question: Should HIV-Negative People in Serodiscordant Relationships All Get PrEP?"},"content":{"rendered":"

\"18480762_blog\"<\/a>From a very thoughtful and experienced primary care provider came this query:<\/p>\n

Hey Paul, quick question —
\nOne of my patients, an HIV-negative gay man, is in a long-term relationship with one of your HIV-positive patients — my patient says his partner has been on successful HIV treatment for years. Obviously I can’t check his partner’s record to confirm this, but my patient\u00a0is quite\u00a0reliable and why should he be lying about this? He says they always\u00a0use condoms.
\nHe asked me today if he should go on PrEP — should he? He seems awfully low risk, denies other sexual exposures, etc.
\nFeel free to suggest that I send him to\u00a0see you for a formal consult.
\nThanks,
\nRoy<\/p>\n

Unless\u00a0you’ve been hiding under a rock (cold and damp down there, isn’t it?), you know by now that pre-exposure prophylaxis (PrEP) works incredibly well to prevent HIV in high risk, seronegative men who have sex with men (MSM) — even better than we thought, according to the recent PROUD<\/a> and IPERGAY<\/a> studies presented at CROI.<\/p>\n

Related to\u00a0my colleague’s query, note that\u00a0the USA guidelines<\/a> clearly state the following is\u00a0an\u00a0indication for PrEP in\u00a0MSM:<\/p>\n

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Is in an ongoing sexual relationship with an HIV-positive male partner\u00a0<\/strong><\/em><\/p>\n

So end of story —\u00a0PrEP should be started, right?<\/p>\n

But there are several reasons\u00a0why it’s not quite so obvious what to do in this exact situation — which is actually quite common:<\/p>\n