PrEP Fundamentals

CE / CME

The Fundamentals of Selecting Individualized HIV PrEP Regimens

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Nurses: 1.00 Nursing contact hour

Released: August 12, 2022

Expiration: August 11, 2023

Activity

Progress
1
Course Completed

References

  1. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2019. HIV Surveillance Supplemental Report 2021;26(No. 2). cdc.gov/hiv/basics/prep/prep-effectiveness.html cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-26-no-2.pdf. Accessed August 5, 2022.
  2. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data reported through June 2021; and preexposure prophylaxis (PrEP) data reported through March 2021. HIV Surveillance Data Tables 2021;2(No. 4). cdc.gov/hiv/pdf/library/reports/surveillance-data-tables/vol-2-no-4/cdc-hiv-surveillance-tables-vol-2-no-4.pdf. Accessed August 5, 2022.
  3. National Center for HIV, Viral Hepatitis, STD, and TB Prevention. PrEP for HIV Prevention in the U.S. 2022. cdc.gov/nchhstp/newsroom/fact-sheets/hiv/PrEP-for-hiv-prevention-in-the-US-factsheet.html. Accessed August 5, 2022.
  4. Preexposure prophylaxis for the prevention of HIV infection in the United States—2021 update. December 2021. cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf. Accessed August 5, 2022.
  5. Marzinke M, Grinsztejn B, Fogel J, et al. Laboratory analysis of HIV infections in HPTN 083: injectable CAB for PrEP. Presented at: 2021 Conference on Retroviruses and Opportunistic Infection; March 6-10, 2021. Abstract 153.
  6. Mayer KH, Molina J-M, Thompson MA, et al. Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, non- inferiority trial. Lancet. 2020;396:239-254.
  7. Emtricitabine/tenofovir disoproxil fumarate prescribing information. Foster City, CA: Gilead Sciences, Inc; 2020.
  8. Saag MS, Gandhi RT, Hoy JF, et al. Antiretroviral drugs for treatment and prevention of HIV infection in adults: 2020 recommendations of the International Antiviral Society-USA Panel. JAMA. 2020;324:1651-1669.
  9. Tan DHS, Hull MW, Yoong D, et al. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis. CMAJ. 2017;189:E1448-E1458.
  10. WHO implementation tool for pre-exposure prophylaxis (PrEP) of HIV infection. 2018 (WHO/CDS/HIV/18.10). apps.who.int/iris/bitstream/handle/10665/279834/WHO-CDS-HIV-18.10-eng.pdf. Accessed August 5, 2022.
  11. Emtricitabine/tenofovir alafenamide prescribing information. Foster City, CA: Gilead Sciences, Inc; 2022.
  12. Cabotegravir prescribing information. Research Triangle Park, NC: ViiV Healthcare; 2021.
  13. Delany-Moretlwe S, Hughes JP, Bock P, et al. Long-acting injectable cabotegravir: updated efficacy and safety results from HPTN 084. The 24th international AIDS Conference; Jul 29 - Aug 2, 2022. Abstract OALBX0107.
  14. European Medicines Agency (EMA) approval of the dapivirine ring for HIV prevention for women in high HIV burden settings. July 2020. who.int/news/item/24-07-2020-european-medicines-agency-(ema)-approval-of-the-dapivirine-ring-for-hiv-prevention-for-women-in-high-hiv-burden-settings. Accessed August 5, 2022.
  15. WHO recommends the dapivirine vaginal ring as a new choice for HIV prevention for women at substantial risk of HIV infection. January 2021. who.int/news/item/26-01-2021-who-recommends-the-dapivirine-vaginal-ring-as-a-new-choice-for-hiv-prevention-for-women-at-substantial-risk-of-hiv-infection. Accessed August 5, 2022.
  16. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587-2599.
  17. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399-410.
  18. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367:423-434.
  19. Choopanya K, Martin M, Suntharasamai P, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381:2083-2090.
  20. Grant RM, Anderson PL, McMahan V, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14:820-829.
  21. McCormack S, Dunn DT, Desai M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387:53-60.
  22. Liu AY, Cohen SE, Vittinghoff E, et al. Preexposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Intern Med. 2016;176:75-84.
  23. Molina JM, Capitant C, Spire B, et al. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373:2237-2246.
  24. Molina JM, Charreau I, Spire B, et al. Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study. Lancet HIV. 2017;4:e402-e410.
  25. Mayer KH, Molina JM, Thompson MA, et al. Emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV pre-exposure prophylaxis (DISCOVER): primary results from a randomised, double-blind, multicentre, active-controlled, phase 3, non-inferiority trial. Lancet. 2020;396:239-254.
  26. Ogbuagu O, Ruane PJ, Podzamczer D, et al. Long-term safety and efficacy of emtricitabine and tenofovir alafenamide vs emtricitabine and tenofovir disoproxil fumarate for HIV-1 pre-exposure prophylaxis: week 96 results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet HIV. 2021;8:e397-e407.
  27. Landovitz RJ, Donnell D, Clement ME, et al. Cabotegravir for HIV prevention in cisgender men and transgender women. N Engl J Med. 2021;385:595-608.
  28. Delany-Moretlwe S, Hughes JP, Bock P, et al. Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial. Lancet. 2022;399:1779-1789.
  29. Landovitz RJ, Donnell D, Tran H, et al. Updated efficacy, safety, and case studies in HPTN 083: CAB-LA vs TDF/FTC for PrEP. Presented at: 2022 Conference on Retroviruses and Opportunistic Infection; February 12-16 and 22-24, 2022. Abstract 96.
  30. Solomon MM, Lama JR, Glidden DV, et al. Changes in renal function associated with oral emtricitabine/tenofovir disoproxil fumarate use for HIV pre-exposure prophylaxis. AIDS. 2014;28:851-859.
  31. Mulligan K, Glidden DV, Anderson PL, et al. Effects of emtricitabine/tenofovir on bone mineral density in HIV-negative persons in a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2015;61:572-580.
  32. Glidden DV, Mulligan K, McMahan V, et al. Metabolic effects of preexposure prophylaxis with coformulated tenofovir disoproxil fumarate and emtricitabine. Clin Infect Dis. 2018;67:411-419.
  33. Liegeon G, Antoni G, Pialoux G, et al. Changes in kidney function among men having sex with men starting on demand tenofovir disoproxil fumarate - emtricitabine for HIV pre-exposure prophylaxis. J Int AIDS Soc. 2020;23:e25420.
  34. Fields SD, Tung E. Patient-focused selection of PrEP medication for individuals at risk of HIV: a narrative review. Infect Dis Ther. 2021;10:165-186.
  35. Marzinke MA, Grinsztejn B, Fogel JM, et al Characterization of human immunodeficiency virus (HIV) infection in cisgender men and transgender women who have sex with men receiving injectable cabotegravir for HIV prevention: HPTN 083. J Infect Dis. 2021;224:1581-1592.
  36. Zhu W, Huang YA, Kourtis AP, Hoover KW. Trends in the number and characteristics of HIV pre-exposure prophylaxis providers in the United States, 2014-2019. J Acquir Immune Defic Syndr. 2021;88:282-289.
  37. Kamitani E, Johnson WD, Wichser ME, et al. Growth in proportion and disparities of HIV PrEP use among key populations identified in the United States national goals: systematic review and meta-analysis of published surveys. J Acquir Immune Defic Syndr. 2020;84:379-386.
  38. Hebel S, Kahn-Woods E, Enghuus C, et al. Disparities in PrEP uptake and adherence among cisgender women using a pharmacologic measure. Open Forum Infect Dis. 2020;7(supp 1):S517-S158.
  39. Mayer KH, Agwu A, Malebranche D. Barriers to the wider use of pre-exposure prophylaxis in the United States: a narrative review. Adv Ther. 2020;37:1778-1811.
  40. gov. Long-acting HIV prevention tools. 2022. hiv.gov/hiv-basics/hiv-prevention/potential-future-options/long-acting-prep. Accessed August 5, 2022.
  41. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. January 2022. clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/whats-new-guidelines. Accessed August 5, 2022.
  42. Mikati T, Jamison K, Daskalakis D. Immediate PrEP initiation at New York City sexual health clinics. Presented at: 2019 Conference on Retroviruses and Opportunistic Infection; March 4-7, 2019. Abstract 962.
  43. Tao L, Carter C, Das M, et al. Real-world utilization of F/TDF and F/TAF for HIV pre-exposure prophylaxis during the COVID-19 pandemic in the United States, December 2019 - June 2020. J Int AIDS Soc. 2021;24:35.