CDC updates its guidelines to encourage doctors to talk everyone who is sexually active about PrEP to prevent HIV

By Jen Christensen, CNN

The US Centers for Disease Control and Prevention is encouraging doctors to talk to all sexually active people about drugs that can help prevent HIV and to prescribe these drugs — known as pre-exposure prophylaxis or PrEP– to anyone who asks for them.

The CDC updated its guidelines Wednesday in the hope that these conversations will encourage more people to protect themselves from getting HIV, Dr. Demetre Daskalakis, the director of CDC’s Division of HIV Prevention, told CNN. The intention is also to make the medication available to people who may be reluctant to disclose potentially stigmatizing behavior that puts them at risk.

“Stigma is our biggest enemy,” Daskalakis said. “I really think this puts PrEP in the same place as so many other really good preventive interventions like talking about smoking, alcohol, drugs, etc.”

PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed, according to the CDC, with few side effects. In 2020 only a quarter of the people who could benefit from the treatment were taking it, according to the CDC.

The CDC recommends people may want to consider PrEP if they have a sexual partner with HIV, if they have sex but don’t consistently use a condom, or they have been diagnosed with a sexually transmitted disease in the past 6 months. It is also recommended for people who share needles to inject drugs or who have an injection partner with HIV.

In 2019, the last year for which the CDC has updated information, the agency estimates 34,800 people were diagnosed with HIV in the US. If untreated, the human immunodeficiency virus or HIV can progress to AIDS.

The rate of new infections had declined slightly over the past four years, but the cases are not evenly distributed, and some communities — communities of color, gay, bisexual and other men who have sex with men — are getting a disproportionate number of the new HIV diagnoses.

The guidance continues to recommend the first PrEP medicine, Truvada, for all genders. It also added a recommendation for the second PrEP medicine approved, Descovy, for sexually active men and transgender women. The drug hadn’t been on the market when the guidance was last revised in 2017. Both are pills people can take once a day. The new guidance also has a section on the first bimonthly injection PrEP drug, cabotegravir, for sexually active men and women, pending FDA approval.

The updated guidelines do not change the groups for whom PrEP is recommended.

“PrEP is one of the most powerful tools we have to prevent HIV transmission,” the CDC wrote in a letter to health care providers. “Expanding access to PrEP will be critical to ending the HIV epidemic in the United States.”

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