HIV Pre-Exposure Prophylaxis Utilization Strategies
Summary
Pre-exposure prophylaxis (PrEP) has emerged as a cornerstone of HIV prevention, employing antiretroviral agents in HIV-negative individuals at substantial risk of infection. Strategies to optimise PrEP utilisation encompass a range of delivery modalities, adherence support mechanisms and equity-centred implementation frameworks. Daily oral PrEP remains the predominant regimen, owing to its established efficacy and ease of integration into routine healthcare. Event-driven oral PrEP offers an alternative for individuals with intermittent risk exposure, reducing cumulative drug intake while maintaining protective effect when properly timed around sexual activity. Long-acting injectable formulations and subdermal implants are advancing through clinical development and demonstration projects, promising to address adherence challenges by extending dosing intervals to months. Effective PrEP rollout also demands robust health systems integration: simplifying prescribing pathways, engaging community stakeholders and deploying digital tools for reminders and telehealth consultations. Tailoring services to marginalised populations—including young people, cisgender women, transgender individuals and residents of rural or resource-limited settings—has become a priority to close gaps in access. Financial coverage schemes, pharmacist-led provision and policy reforms such as Medicaid expansion have demonstrated tangible impacts on uptake. Modelling studies and real-time surveillance of prescription data inform forecasting of future coverage goals, while equity metrics guide targeted interventions. Collectively, these strategies converge on a global ambition to reduce HIV incidence and move towards the elimination of new infections by 2030.
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HIV Pre-Exposure Prophylaxis Utilization Strategies publication trend
The graph below shows the total number of articles in hiv pre-exposure prophylaxis utilization strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Pre-Exposure Prophylaxis (PrEP): Administration of antiretroviral medication to HIV-negative individuals before potential exposure, reducing the risk of acquisition.
Event-Driven PrEP: A dosing regimen in which oral antiretroviral tablets are taken before and after sexual activity rather than daily.
Long-Acting Injectable PrEP: Intramuscular antiretroviral injections administered at extended intervals (e.g. monthly or bi-monthly) to enhance adherence.
PrEP-to-Need Ratio (PnR): A metric comparing the proportion of individuals using PrEP to the estimated number of people at substantial risk of HIV.
Adherence: The extent to which individuals follow the prescribed PrEP regimen in timing and dosage, critical for maintaining efficacy.
References
- Equity of PrEP uptake by race, ethnicity, sex and region in the United States in the first decade of PrEP: a population-based analysis. The Lancet Regional Health - Americas (2024).
- Dynamics of HIV PrEP use and coverage during and after COVID-19 in Germany. BMC Public Health (2024).
- Who prefers what? Correlates of preferences for next‐generation HIV prevention products among a national U.S. sample of young men who have sex with men. Journal of the International AIDS Society (2023).
- Access to PrEP and other sexual health services for cisgender women in the United States: a review of state policy and Medicaid expansion. Frontiers in Public Health (2024).
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