The 2017 updated clinical practice guideline for<unk> P published by the Centers for Disease Control and<unk> vention (CDC) In the United States, federal guidelines recommend the use of<unk>  <unk> P) for HIV-negative adults with the following characteristics: * sexually active in the last 6 months and NOT in a sexually monogamous relationship with a recently tested HIV-negative partner, and who... * is a man who has sex with men (MSM), and who... * has had anal sex with another man in the past 6 months without a condom, or... * has had a sexually transmitted infection in the past 6 months * or is a sexually active adult (male or female with male or female partners), and who... * is a man who has sex with both men and women, or... * has sex with partners at increased risk of having HIV (e.g. injection drug users, men who have sex with men) without consistent condom use * or anyone who has injected illicit drugs in the past six months, shared recreational drug injection equipment with other drug users in the past six months, or who has been in treatment for injection drug use in the past six months In the United Kingdom the BHIVA/BASHH guidelines on the use of HIV<unk>  <unk> P) 2018 recommend: *On-demand or daily oral Tenofovir - emtricitabine (TD-FTC) for HIV-negative MSM who are at elevated risk of HIV acquisition through unprotected anal sex in the<unk> vious 6 months and ongoing unprotected anal sex. *On-demand or daily oral TD-FTC for HIV-negative MSM having unprotected anal sex with partners who are HIV positive, unless the partner has been on ART for at least 6 months and their plasma viral load is <200 copies/mL. *Tenofovir (TDF) alone should not be offered to MSM. *Daily oral TD-FTC for HIV-negative heterosexual men and women having unprotected sex with partners who are HIV positive, unless the partner has been on ART for at least 6 months and their plasma viral load is <200 copies/mL. *Daily oral TD-FTC for heterosexual men and women on a case-by-case basis with current factors that may put them at increased risk of HIV acquisition. *TDF alone can be offered to heterosexual men and women where FTC is contraindicated. *PrEP is not recommended for people who inject drugs where needle exchange and opiate substitution programs are available and accessed by the individual. *PrEP with daily oral TD-FTC for HIV-negative trans women who are at risk of HIV acquisition through unprotected anal sex in the<unk> vious 6 months and ongoing unprotected sex. *Daily oral TD-FTC for HIV-negative trans women and trans men who have unprotected sex with partners who are HIV positive, unless the partner has been on ART for at least 6 months and their plasma viral load is <200 copies/mL. Other government health agencies from around the world have devised their own national guidelines for how to use<unk> P to<unk> vent HIV infection in those at high risk, including Botswana, Canada, Kenya, Lesotho, South Africa, Uganda, the Zambia, and Zimbabwe. Often, laboratory testing is required before starting<unk> P, including a test for HIV. Once<unk> P is initiated, individuals are asked to see their provider at least every three to six months. During those visits, healthcare providers may want to repeat testing for HIV, test for other sexually transmitted infections, monitor kidney function, and/or test for<unk> gnancy. Individuals must test negative for HIV prior to<unk> P initiation, because persons infected with HIV taking<unk> P medication are at risk for becoming resistant to emtricitabine. Consequently, these people with HIV infection and resistance to emtricitabine will have less options for selecting HIV treatment medications.<unk> P has been shown to be effective at reducing the risk of acquiring HIV in individuals at increased risk. However,<unk> P is not 100% effective at<unk> venting HIV, even in people who take the medication as<unk> scribed. There have been several reported cases of people who acquired HIV despite taking<unk> P. People taking<unk> P may use combination<unk> vention strategies along with<unk> P, like condoms. If someone on<unk> P acquires HIV, they may experience the signs and symptoms of HIV/AIDS.<unk> P is typically taken continuously and daily following potential<unk> . The CDC recommends follow-up visits at least every 3 months to provide HIV tests, medication adherence counseling, behavioral risk reduction support, side effect assessment, STI symptom assessment, and STI testing for sexually active individuals with symptoms of a current infection.<unk> gnancy tests should also be done every 3 months for woman who may become<unk> gnant. At 3 months and every 6 months thereafter, renal function and<unk> sence of bacterial STI is assessed. Effectiveness of<unk> P is associated with adherence, with effectiveness decreasing with suboptimal adherence. Although the daily, oral dosing schedule is still recommended for all individuals taking<unk> P medication for HIV infection<unk> vention, event-driven<unk> , or ED-PrEP, is an option for men who have sex with men. ED-PrEP is also referred to as "2+1+1" dosing, because the dosing regimen involves a person taking two pills two to twenty-four hours prior to sex, one pill twenty-four hours after taking the first two pills, and a last pill taken forty-eight hours after taking the first two pills. This dosing regimen was first proven effective to reduce the relative risk of HIV infection by 86% in the IPERGAY randomized clinical trial performed in Canada and France in 2015. This has only been evaluated with Truvada and not other drugs. According to the WHO, ED-PrEP should be considered for HIV infection<unk> vention in men who have sex with men who have relatively infrequent sex, who are able to plan sex or delay sex for about two hours, and who find this dosing schedule convenient. ED-PrEP is not recommended for use in other populations, such as cisgender or transgender women and men who have vaginal and/or anal sex with women, due to the lack of safety and efficacy data available studying ED-PrEP in these populations. ED-PrEP can be beneficial to help reduce pill burden for people and decrease costs, as fewer pills are needed. In 2016, the World Health Organization (WHO) consolidated guidelines regarding the use of antiretroviral drugs for treatment and<unk> vention of HIV infection support the use of<unk> P in<unk> gnant and breastfeeding women who are at continued and substantial risk of HIV infection. In clinical<unk> P trials,<unk>  to TDF-containing<unk> P during the first trimester of<unk> gnancy was not associated with adverse<unk> gnancy or infant outcomes. The increased risk of mother-to-child HIV transmission outweigh any potential risks of<unk> P. The guidelines also note the need for continued monitoring of<unk> gnant and breastfeeding women receiving<unk> P. However, global<unk> P accessibility for women, including those who are either<unk> gnant or breastfeeding, is limited. Efforts to increase accessibility to women who are at risk for HIV are necessary in reducing rates of global HIV infections.
Pre-exposure prophylaxis
Post-exposure prophylaxis
Transmission-based precautions
Protective isolation
Vaccine storage
Vaccine therapy
Pulse vaccination strategy
Vaccine bundling