Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Current guidance on the use of pre-exposure prophylaxis (PrEP) for patients at high risk of HIV exposure:
- PrEP should be offered to people at higher risk of HIV infection, using the criteria outlined in the British HIV Association (BHIVA) and British Association for Sexual Health and HIV (BASHH) guidelines NICE NG221.
- PrEP involves taking antiretroviral tablets daily (daily PrEP) or, in some cases, event-based or on-demand dosing NICE NG221.
- Specialist input is required at initiation and for ongoing monitoring of PrEP, including regular HIV testing and screening for sexually transmitted infections every 3 months NICE NG221,NICE CKS,NICE CKS.
- Primary care is not expected to prescribe PrEP but should support the broader HIV prevention strategy by offering HIV testing, condom provision, adherence encouragement, and discussing PrEP availability NICE CKS,NICE CKS.
- People taking PrEP should receive tailored information on effectiveness, adherence, side effects, and monitoring risks, and be supported to maximise adherence NICE NG221.
- Kidney function and other potential adverse health events should be monitored during PrEP use NICE NG221.
- Services offering PrEP should be accessible and welcoming to all eligible groups, with clear referral pathways from services that do not provide PrEP NICE NG221.
- Awareness of PrEP should be raised among healthcare professionals and local communities, especially in groups with lower uptake or awareness, such as trans people, cisgender women, young people, and people from Black African or Caribbean backgrounds NICE NG221.