Strategies to reduce new HIV infections span multifaceted efforts, including safe-sex counseling, voluntary medical male circumcision, treatment as prevention, and pre- (PrEP) and postexposure prophylaxis. PrEP entails the use of antiretroviral (ARV) drugs prophylactically by HIV-negative individuals at risk of infection to thwart acquisition of the virus.
In 2012, the US Food and Drug Administration (FDA) approved Truvada, a daily oral pill for PrEP comprising 2 reverse transcriptase inhibitors, tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). This landmark approval was followed by approval from several other countries in North America and South America, Europe, and Africa. Support for oral PrEP emerged through pivotal randomized controlled trials investigating Truvada in men who have sex with men (MSM),1-3 serodiscordant heterosexual couples in Kenya and Uganda,4 heterosexual men and women in Botswana,5 and users of injection drugs in Thailand.6 The 2015 guidelines from the World Health Organization recommend oral PrEP for all populations at significant risk of HIV infection.7
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