Update to Interim Guidance for Preexposure Prophylaxis (PrEP) for the Prevention of HIV Infection: PrEP for Injection Drug Users

July 2013 - Reports, Guidelines, and Tools

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Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). (June 14, 2013). Vol. 62 No. 23, pp. 463-465.

Following a Thailand Ministry of Health and Centers for Disease Control and Prevention (CDC) randomized controlled trial of daily oral dose of tenofovir disoproxil fumarate (TDF)—showing TDF's effectiveness in reducing HIV infection among people who inject drugs (PWID—the CDC recommends that pre-exposure prophylaxis (PrEP) be considered as an HIV prevention strategy for PWID in the United States (U.S). The CDC recommends the daily TDF/emtricitabine (FCT) regimen for PrEP with PWID because TDF/FTC contains the same dosage of TDF (300 mg) that was effective in the trial; showed no additional toxicities compared to TDF alone in other trials; is indicated for those at HIV risk through sexual acquisition; and is approved in the U.S. for PrEP. Several clinical trials have shown the safety and efficacy of daily, oral PrEP, with high adherence, for other populations, and the CDC previously issued guidance for PrEP with men who have sex with men and heterosexually active adults. The current interim guidance was developed by a CDC workgroup with external experts and stakeholders. Adherence to daily oral PrEP is critical for effectiveness, and can be challenging. However, according to the CDC, PrEP for PWID could help reduce HIV incidence in the U.S.

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