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HEALTH CARE

PrEP shown to reduce
the spread of HIV

By C. Junda Woo, MD

Four years after the FDA approved a pill to prevent HIV in 2012, many primary care providers remain unfamiliar with it. PrEP, or
pre-exposure prophylaxis for HIV, consists of emtricitabine/tenofovir, taken by people who are HIV negative but at high risk of infection.
Taken consistently, PrEP cuts the chance of acquiring HIV by up to 90 pecent and could prevent 48,200 U.S. cases by the year 2020
[1].

The CDC recommends PrEP for people with an HIV-positive partner, or anyone else at high risk — for example, if a man who has sex
with men (MSM) engages in condomless sex or had a recent sexually transmitted infection. Heterosexuals who have unprotected sex with
intravenous drug users or with bisexual men also are candidates. And intravenous drug users who share needles should also be offered PrEP.

In MSM and African-Americans, the prevalence of HIV is staggering. Literally half of African-American MSM in the United States
will acquire HIV in their lifetimes. So will 1 in 4 Latino MSM and 1 in 11 white MSM (Figure 1). Among African-American men of
any sexual orientation, 1 in 20 will acquire HIV in their lifetimes (Figure 2). The elevated risk for African-Americans comes mostly from
having sex in a community where HIV is common, and not from unusually reckless behavior. Multiple studies show that black people
actually are more likely to use condoms than people of other races [2].
36 San Antonio Medicine • November 2016