Oral pre-exposure prophylaxis (PrEP) for prevention of HIV in serodiscordant heterosexual couples in the United States: Opportunities and challenges

James M. McMahon, Julie E. Myers, Ann E. Kurth, Stephanie E. Cohen, Sharon B. Mannheimer, Janie Simmons, Enrique R. Pouget, Nicole Trabold, Jessica E. Haberer

Research output: Contribution to journalArticle

Abstract

Oral HIV pre-exposure prophylaxis (PrEP) is a promising new biomedical prevention approach in which HIV-negative individuals are provided with daily oral antiretroviral medication for the primary prevention of HIV-1. Several clinical trials have demonstrated efficacy of oral PrEP for HIV prevention among groups at high risk for HIV, with adherence closely associated with level of risk reduction. In the United States (US), three groups have been prioritized for initial implementation of PrEP - injection drug users, men who have sex with men at substantial risk for HIV, and HIV-negative partners within serodiscordant heterosexual couples. Numerous demonstration projects involving PrEP implementation among MSM are underway, but relatively little research has been devoted to study PrEP implementation in HIV-serodiscordant heterosexual couples in the US. Such couples face a unique set of challenges to PrEP implementation at the individual, couple, and provider level with regard to PrEP uptake and maintenance, adherence, safety and toxicity, clinical monitoring, and sexual risk behavior. Oral PrEP also provides new opportunities for serodiscordant couples and healthcare providers for primary prevention and reproductive health. This article provides a review of the critical issues, challenges, and opportunities involved in the implementation of oral PrEP among HIV-serodiscordant heterosexual couples in the US.

Original languageEnglish (US)
Pages (from-to)462-474
Number of pages13
JournalAIDS patient care and STDs
Volume28
Issue number9
DOIs
StatePublished - Sep 1 2014

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

McMahon, J. M., Myers, J. E., Kurth, A. E., Cohen, S. E., Mannheimer, S. B., Simmons, J., Pouget, E. R., Trabold, N., & Haberer, J. E. (2014). Oral pre-exposure prophylaxis (PrEP) for prevention of HIV in serodiscordant heterosexual couples in the United States: Opportunities and challenges. AIDS patient care and STDs, 28(9), 462-474. https://doi.org/10.1089/apc.2013.0302