The US Centers for Disease Control and Prevention (CDC) has released new guidelines recommending that pre-exposure prophylaxis (PrEP) should be considered for anyone HIV-negative who has a sexual partner with HIV.
The guidelines also recommend PrEP for any gay man who has had a sexually transmitted infection (STI) or who has had sex without a condom in the last six months, any non-gay person who has had condomless sex in the last six months with someone at high risk of HIV, or anyone who in the last six months has injected drugs and shared equipment. While the CDC recommends that the benefits of condom use are also explained, especially to people with inconsistent PrEP adherence, they do not say that condoms should be provided alongside PrEP or that PrEP and condoms should be used together.
The US Food and Drug Administration (FDA) approved the use of Truvada (tenofovir plus emtricitabine) as PrEP in 2012, but did not make recommendations as to who should be considered for PrEP. The CDC issued previous guidelines in July 2011, but these were only for gay men, did not go into detail about who should be offered PrEP other than that they should be at “substantial risk”, and mandated condom distribution alongside PrEP.
Comment: The New York Times in an article commented that the CDC's recommendations "could transform AIDS prevention in the United States". However, the attitudes of healthcare workers and the willingness of health insurance funders to pay for PrEP will be key to any expansion of what is still not a widely used prevention method.