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    Understanding HIV Pre-Exposure Prophylaxis Questions of U.S. Health Care Providers: Unique Perspectives from the PrEPline Clinical Teleconsultation Service
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    Abstract:
    Fewer than a quarter of people considered to have factors associated with HIV acquisition are prescribed pre-exposure prophylaxis (PrEP) in the United States. Prior studies demonstrate disparities in provider comfort and knowledge regarding PrEP, suggesting a need for provider capacity building to support widespread PrEP availability. This study examined real-world PrEP clinical questions/cases from providers to a teleconsultation service to identify knowledge gaps and improve PrEP-related training materials and clinical guidelines.
    Keywords:
    Pre-exposure prophylaxis
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    HIV pre‐exposure prophylaxis (PrEP) is the use of antiretrovirals by HIV negative individuals to reduce the risk of HIV infection. In this article the authors give an overview of the evidence for PrEP among key populations and practical considerations regarding HIV and PrEP risk assessment, delivery and monitoring.
    Pre-exposure prophylaxis
    Primary Prevention
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    Pre-exposure prophylaxis (PrEP) for HIV is a proven and effective tool for preventing HIV. However, there are instances where individuals taking PrEP have contracted HIV infection. Most of these cases are due to nonadherence to the drug, while other cases of apparent PrEP failure are due to unrecognized HIV infection at baseline. Importantly, there are also now at least three well-documented cases of PrEP failing despite adequate adherence; these are cases of PrEP 'breakthrough'. This article outlines the potential mechanisms of PrEP failure, as well as how to identify and manage these patients. Finally, we provide a perspective on the future of PrEP as a key tool in preventing HIV worldwide.
    Pre-exposure prophylaxis
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