Government panel offers strongest recommendation for PrEP to prevent HIV

The US Preventive Services Task Force (USPSTF) published its strongest recommendation that clinicians should prescribe pre-exposure prophylaxis (PrEP) with effective antiretroviral therapy to people at increased risk of HIV acquisition.

Carl Schmid

The recommendations in JAMA on Tuesday came as part of an update to a 2019 review, and USPSTF gave its blessing to oral PrEP, which is associated with decreased risk of acquiring HIV infection compared with placebo or no PrEP. USPSTF added that Gilead’s Descovy was non-inferior to its Truvada brand and that the injectable cabotegravir (ViiV Healthcare’s Apretude) reduced the risk of HIV infection compared with Truvada in the populations studied.

Carl Schmid, executive director of the HIV+Hepatitis Policy Institute, said in an emailed statement:

Including a long-acting drug as part of the USPSTF PrEP recommendation is an important step in improving HIV prevention efforts in the United States. While daily oral PrEP is highly effective, adherence can be an issue. That is why the FDA called long-acting PrEP superior to daily oral PrEP. With PrEP uptake deeply lagging in Black and Latino communities compared to Whites, long-acting PrEP can be a game-changer.

The recommendations come as an estimated 1.2 million Americans currently have HIV. More than 760,000 have died of HIV-related complications since 1981.

Meanwhile, the Biden administration is still fighting in court to keep PrEP covered at no cost, after a Texas judge ruled unconstitutional the Affordable Care Act’s mandate requiring the coverage of preventative services, including PrEP, saying they violate some peoples’ religious beliefs. Pharma companies criticized the ruling last September.

“We’re still seeing that many people who could benefit from PrEP aren’t receiving this highly effective medication, particularly in Black, Hispanic, and Latino communities,” USPSTF member James Stevermer said in a statement. “It’s critical for healthcare professionals to keep these disparities in mind and to have conversations with patients who are at risk about proven ways to prevent HIV, including taking PrEP.”

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