The American Medical Association (AMA) recently adopted new policies that recognize the need for better education of physicians on the effective use of pre-exposure prophylaxis (PrEP) to prevent HIV acquisition.

Although the US Food and Drug Administration (FDA) approved PrEP in July 2012, a 2015 survey by the Centers for Disease Control and Prevention (CDC) found that 34% of primary care doctors and nurses had never heard of PrEP.

“With more than 1.2 million people in the United States living with substantial risk of HIV infection but fewer than 5% taking PrEP, there is significant ground to gain in stemming the incidence of HIV,” AMA Board Member Jesse M. Ehrenfeld, MD, said in a press release. “Educating physicians about the effective use of PrEP and encouraging insurers to cover the costs associated with its administration will make the transmission of HIV rarer and our nation healthier.”


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The 2014 guidelines from the US Public Health Service recommended PrEP as prevention in individuals at high risk for infection and cautioned that high medication adherence is critical to PrEP efficacy.

Tenofovir/emtricitabine (Truvada®, Gilead) is a once-a-day prevention option for HIV-negative men and women that reduces the risk of sexual HIV acquisition. The average price of tenofovir/emtricitabine in the United States is $1,539.90 for 30 tablets.

Accordingly, the AMA also adopted two additional policies related to PrEP. AMA officials said they will advocate that all insurers be required to cover the costs associated with the administration of PrEP and that the AMA will work with government officials to study the feasibility of providing PrEP free of charge to individuals who may be at high risk.

The recently adopted policies build on years of AMA efforts to bolster education and training to combat HIV/AIDS and to increase multilayer collaboration to enhance public awareness.

PrEP has been shown to reduce the risk of getting HIV from sex by more than 90% when used consistently.2-4 In a clinical trial of people who injected drugs, consistent use of PrEP halved the risk of getting HIV.5

Reference

  1. AMA Urges Greater Physician Education on Effective Use of Once-A-Day HIV Prevention Option [press release]. Chicago, IL: American Medical Association; June 15, 2016.

  2. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587-2599.

  3. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423-434.

  4. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399-410.

  5. Choopanya K, Martin M, Suntharasamai P, et al. Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomized, double-blind, placebo-controlled phase 3 trial. Lancet. 2013;381(9883):2083-2090.