HIV preexposure prophylaxis in the real world

According to evolving guidelines, candidates for HIV preexposure prophylaxis (PrEP) include HIV-uninfected men who have sex with men who engage in condomless anal intercourse, individuals in HIV-serodifferent sexual relationships, those with frequent anogenital sexually transmitted infections, and those who have received repeated nonoccupational postexposure prophylaxis treatment courses. In the real-world setting, indications for PrEP and management of PrEP candidates and patients maybe less than clear-cut. Factors to be considered when assessing candidacy for PrEP and maximizing efficacy of treatment are discussed. This article summarizes a presentation by Demetre C. Daskalakis, MD, MPH, at the IAS-USA continuing education program held in Los Angeles, California, in April 2014.