Journal article
Preexposure Prophylaxis for the Prevention of HIV Infection US Preventive Services Task Force Recommendation Statement
JAMA : the journal of the American Medical Association, Vol.321(22), pp.2203-2213
06/11/2019
DOI: 10.1001/jama.2019.6390
PMID: 31184747
Abstract
IMPORTANCE An estimated 1.1 million individuals in the United States are currently living with HIV, and more than 700 000 persons have died of AIDS since the first cases were reported in 1981. In 2017, there were 38 281 new diagnoses of HIV infection reported in the United States; 81% of these new diagnoses were among males and 19% were among females. Although treatable, HIV infection has no cure and has significant health consequences.
OBJECTIVE To issue a new US Preventive Services Task Force (USPSTF) recommendation on preexposure prophylaxis (PrEP) for the prevention of HIV infection.
EVIDENCE REVIEW The USPSTF reviewed the evidence on the benefits of PrEP for the prevention of HIV infection with oral tenofovir disoproxil fumarate monotherapy or combined tenofovir disoproxil fumarate and emtricitabine and whether the benefits vary by risk group, population subgroup, or regimen or dosing strategy; the diagnostic accuracy of risk assessment tools to identify persons at high risk of HIV acquisition; the rates of adherence to PrEP in primary care settings; the association between adherence and effectiveness of PrEP; and the harms of PrEP when used for HIV prevention.
FINDINGS The USPSTF found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV acquisition. The USPSTF also found convincing evidence that adherence to PrEP is highly associated with its efficacy in preventing the acquisition of HIV infection; thus, adherence to PrEP is central to realizing its benefit. The USPSTF found adequate evidence that PrEP is associated with small harms, including kidney and gastrointestinal adverse effects. The USPSTF concludes with high certainty that the magnitude of benefit of PrEP with oral tenofovir disoproxil fumarate-based therapy to reduce the risk of acquisition of HIV infection in persons at high risk is substantial.
CONCLUSIONS AND RECOMMENDATION The USPSTF recommends offering PrEP with effective antiretroviral therapy to persons at high risk of HIV acquisition. (A recommendation)
Details
- Title: Subtitle
- Preexposure Prophylaxis for the Prevention of HIV Infection US Preventive Services Task Force Recommendation Statement
- Creators
- Douglas K. Owens - Stanford UniversityKarinaW Davidson - United States Preventive Services Task ForceAlex H. Krist - Virginia Commonwealth UniversityMichael J. Barry - Harvard UniversityMichael Cabana - University of California, San FranciscoAaron B. Caughey - Oregon Health & Science UniversitySusan J. Curry - University of IowaChyke A. Doubeni - Univ Penn, Philadelphia, PA 19104 USAJohn W. Epling - Virginia TechMartha Kubik - Temple UniversityC. Seth Landefeld - University of Alabama at BirminghamCarol M. Mangione - University of California, Los AngelesLori Pbert - University of Massachusetts Chan Medical SchoolMichael Silverstein - Boston UniversityMelissa A. Simon - Northwestern UniversityChien-Wen Tseng - Honolulu UniversityJohn B. Wong - Tufts UniversityUS Preventive Services Task Force
- Resource Type
- Journal article
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.321(22), pp.2203-2213
- Publisher
- Amer Medical Assoc
- DOI
- 10.1001/jama.2019.6390
- PMID
- 31184747
- ISSN
- 0098-7484
- eISSN
- 1538-3598
- Number of pages
- 11
- Grant note
- P30CA086862 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 06/11/2019
- Academic Unit
- Health Management and Policy; Community and Behavioral Health
- Record Identifier
- 9984366377302771
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