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Analyzing Annals: Beyond the Guidelines: Preexposure Prophylaxis for HIV Prevention
Preexposure prophylaxis (PrEP) for HIV prevention is recommended for those at high risk for HIV infection. This multimedia feature includes a video interview with a patient, a video of a Grand Rounds debate between 2 experts in HIV care, supplemental slides, and the accompanying paper. It addresses the care of a patient for whom the application of current clinical care recommendations is not clear-cut.
Use this feature to consider the following:
- Watch the patient interview. Would you recommend that Mr. X use PrEP?
- Review with which patients are considered at high risk for HIV infection and for whom PrEP is recommended. What factors affect the sexual transmissibility of HIV? Use the table in the paper. Do you know how to prescribe PrEP? How effective is it? What are its side effects and costs? These are discussed in the Grand Rounds presentation and paper.
- Review the questions in Table 3. Do you think that incorporating PrEP into clinical practice sends a “mixed message” (by disinhibiting some patients, increasing transmission risk, and/or increasing the risk for other sexually transmitted infections)?
- Watch the Grand Rounds discussion. What do you recommend now?