Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

  • L Bekker University of Cape Town
  • K Rebe Anova Health Institute
  • F Venter University of the Witwatersrand
  • G Maartens University of Cape Town
  • M Moorhouse University of the Witwatersrand
  • F Conradie University of the Witwatersrand
  • C Wallis BARC & Lancet Laboratories
  • V Black University of the Witwatersrand
  • B Harley
  • R Eakles University of the Witwatersrand
Keywords: Southern African guidelines, safe use, pre-exposure prophylaxis, HIV-1 infection

Abstract

The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP) guidelines in June 2012 for men who have sex with men (MSM) who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO) Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

Author Biographies

L Bekker, University of Cape Town
The Desmond Tutu HIV Centre University of Cape Town South Africa
K Rebe, Anova Health Institute
Anova Health Institute Johannesburg South Africa
F Venter, University of the Witwatersrand
Wits Reproductive Health and HIV Institute Johannesburg South Africa
G Maartens, University of Cape Town
Department of Medicine University of Cape Town South Africa
M Moorhouse, University of the Witwatersrand
Wits Reproductive Health and HIV Institute Johannesburg South Africa
F Conradie, University of the Witwatersrand
Right to Care and Clinical HIV Research Unit University of the Witwatersrand South Africa
C Wallis, BARC & Lancet Laboratories
BARC & Lancet Laboratories Johannesburg South Africa
V Black, University of the Witwatersrand
Wits Reproductive Health and HIV Institute Johannesburg South Africa
B Harley
City Health City of Cape Town South Africa
R Eakles, University of the Witwatersrand
Wits Reproductive Health and HIV Institute Johannesburg South Africa
Issue
Vol 58 No 5: September/October 2016
Section
Review Articles
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