Antiretroviral pre-exposure prophylaxis implementation in the United States: a work in progress

摘要: Introduction: After the initial approval of use tenofovir disoproxil fumarate-emtricitabine (TDF/FTC) by US Food and Drug Administration in 2012 for anti-HIV pre-exposure prophylaxis (PrEP), uptake was initially limited, but more recent community surveys expert opinion suggest wider acceptance some key populations. Discussion:DemonstrationprojectsareunderwaytodeterminethebestpracticesintheUnitedStatestoidentifyat-riskindividuals primary care sexually transmitted disease clinics who could benefit from PrEP. Studies PrEP combination with behavioural interventions are being evaluated. to evaluate HIV-uninfected women HIV-discordant couples interested safe conception also getting underway. The optimal deployment as part a comprehensive national HIV/AIDS strategy United States has been limited lack knowledge among at-risk people medical providers indicating that they do not feel sufficiently knowledgeable comfortable prescribing underway determine how assist busy clinicians which their patients Although most federal health insurance programmes will cover costs associated PrEP, underinsured states have enacted reform face additional challenges paying medication appropriate clinical monitoring. Conclusions: implementation is work progress, increasing awareness individuals