Spotlight Center on HIV Prevention Today

Getting Comfortable With PrEP: A Provider's Perspective

March 26, 2014

Dr. Joel Gallant

Dr. Joel Gallant

PrEP, short for pre-exposure prophylaxis, is a relatively new HIV prevention strategy in which an HIV-negative person takes a daily pill to reduce the risk for acquiring HIV. The sole drug currently approved for PrEP is Truvada -- a combination antiretroviral that is widely prescribed for HIV treatment.

Results from extensive clinical trials show that PrEP works when people take it; in fact, an analysis of blood drug levels among participants in the global iPrEx trial puts protection at 99% or more when individuals take PrEP daily as prescribed.

That said, PrEP isn't perfect; it does not prevent other sexually transmitted infections, for example, and not everyone is willing or able to take a pill every day. But for people at high risk for HIV infection who do want to use PrEP, shouldn't they be supported in their HIV prevention efforts?

Longtime HIV doc Joel Gallant, MD, MPH, says yes. "Let's agree that abstinence is the only prevention method that's 100% effective, but that abstinence is unacceptable to most human beings," he writes on his "Ask Dr. Joel" blog. "Everything else -- condoms and PrEP included -- are imperfect but effective ways to prevent HIV infection. We should embrace the strategy of harm reduction, and not deny access to prevention tools that have been clearly shown to work."

In this Q&A, Dr. Gallant offers his perspective on some health care providers' reluctance to prescribe PrEP, the difference between managing patients on antiretroviral PrEP and individuals taking the same meds for HIV treatment, and how non-HIV-specialists can get comfortable prescribing PrEP and working with those who stand to benefit from it the most.

This excerpt was cross-posted with the permission of Read the full article.

This article was provided by BETA. Visit their website at

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