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PrEP
Pre-Exposure Prophylaxis
Lori Miller
AVAC: Global Advocacy for HIV Prevention
22 MAY 2010
What is PrEP?
 Experimental HIV prevention strategy that would
use antiretrovirals (ARVs) to reduce the risk of HIV
infection in HIV-negative people
 In this strategy, people would take a single drug, or
a combination of drugs, before exposure to HIV,
with the hope that it would lower their risk of
infection
 PrEP is still experimental and has not yet been
shown to work in humans
PrEP Agents in Effectiveness Trials
 Oral PrEP
• tenofovir disoproxil fumarate -TDF
Brand name: Viread
• tenofovir plus emtricitabine – TDF/FTC
Brand name: Truvada
 Topical PrEP
• tenofovir gel
Current Ideas on How PrEP Could be Used
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Oral: daily
Oral: intermittently
Topical: gel
Topical: vaginal ring, other formulations
Injection, long-term acting methods
Concerns about PrEP
 Long-term drug for healthy people: different risk benefit ratio
 Potential for side effects and toxicity over time
 Potential for resistance: current agents being studied are used
for HIV treatment
 Adherence for healthy people
 HIV testing would be required for PrEP access and on an
ongoing basis
 With limited resources for HIV treatment, is it appropriate
to use ARVs for prevention?
 Delivery in resource limited settings
The PrEP Pipeline
 Oral: largely based on tenofovir
 Topical: robust pipeline with many compounds
being considered
 Injectable: TMC 278LA
Thank you!