New Regimens, Similar Conclusions for PrEP. Do They Change Anything for Urgent Care?

The U.S. Preventive Services Task Force reported 4 years ago that oral preexposure prophylaxis (PrEP) reduced the likelihood of HIV infection in adults at increased risk for infection. At the time, offering PrEP in urgent care was a controversial prospect; while there was little debate as to the public health benefits, some UC operators found the complex side-effects profile daunting for a setting largely dedicated to episodic care. Now a meta-analysis of newer PrEP regimens has been published by the Journal of the American Medical Association. Drawing from randomized clinical trials of PrEP vs placebo or no PrEP, or newer vs older PrEP regimens and diagnostic accuracy studies on predicting incident HIV infection, the authors found oral tenofovir alafenamide/emtricitabine (TAF/FTC) to be noninferior to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in men who have sex with men, and long-acting injectable cabotegravir to be associated with decreased risk of HIV infection vs oral TDF/FTC in cisgender men who have sex with men and transgender women. Overall, they concluded that “oral TAF/FTC was noninferior to oral TDF/FTC, and injectable cabotegravir reduced the risk of HIV infection compared with oral TDF/FTC in the populations studied.” JUCM has published a pair of articles on the viability of offering PrEP services. Read Initiating PrEP Services in Urgent Care and Is PrEP Appropriate for Urgent Care? in our archive for more insights.