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Clinical Summary

Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Population Persons at high risk of HIV acquisition
Recommendation Offer preexposure prophylaxis (PrEP).
Grade: A
Risk Assessment Persons at risk of HIV infection include men who have sex with men, persons at risk via heterosexual contact, and persons who inject drugs. Within these groups, certain risk factors or behaviors (outlined below) can place persons at high risk of HIV infection.

Men who have sex with men, are sexually active, and have 1 of the following characteristics:

  • A serodiscordant sex partner (ie, in a sexual relationship with a partner living with HIV)
  • Inconsistent use of condoms during receptive or insertive anal sex
  • An STI with syphilis, gonorrhea, or chlamydia within the past 6 months

Heterosexually active women and men who have 1 of the following characteristics:

  • A serodiscordant sex partner (ie, in a sexual relationship with a partner living with HIV)
  • Inconsistent use of condoms during sex with a partner whose HIV status is unknown and who is at high risk (eg, a person who injects drugs or a man who has sex with men and women)
  • An STI with syphilis or gonorrhea within the past 6 months

Persons who inject drugs and have 1 of the following characteristics:

  • Shared use of drug injection equipment
  • Risk of sexual acquisition of HIV (see above)
Persons who engage in transactional sex, persons who are trafficked for sex work, men who have sex with men and women, and transgender women and men who are sexually active can be at high risk of HIV infection, and should be considered for PrEP based on the criteria outlined above.
Preventive Medication Once-daily oral treatment with combined tenofovir disoproxil fumarate and emtricitabine is the only formulation of PrEP currently approved by the US Food and Drug Administration for use in the United States in persons at risk of sexual acquisition of HIV infection.
Relevant USPSTF Recommendations The USPSTF has issued recommendations on behavioral counseling to reduce risk of STIs and on screening for HIV infection.

Abbreviations: HIV=human immunodeficiency virus; STI=sexually transmitted infection

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to https://www.uspreventiveservicestaskforce.org.

Current as of: June 2019

Internet Citation: Clinical Summary: Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis. U.S. Preventive Services Task Force. June 2019.
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/prevention-of-human-immunodeficiency-virus-hiv-infection-pre-exposure-prophylaxis

USPSTF Program Office   5600 Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857