title: Challenges and opportunities for oral pre-exposure prophylaxis in the prevention of HIV infection: where are we in Europe?
abstract: Following US Food and Drugs Administration approval in July 2012 of daily oral tenofovir and emtricitabine for pre-exposure prophylaxis (PrEP) to prevent HIV infection in high-risk individuals in the USA, there has been much controversy about the implementation of this PrEP regimen in other countries throughout the world, and in Europe in particular. In this review, we focus on the challenges and opportunities of a daily oral PrEP regimen to curb the rising incidence of HIV infection in high-risk groups, and particularly in men who have sex with men. A number of issues would need to be addressed before PrEP could be implemented, including assessing the real effectiveness and cost-effectiveness of daily PrEP, the sustainability of daily adherence, the risk of selecting resistance, the long-term safety, and the risk of change in sexual behavior that might offset the benefit of PrEP. Alternatives to a daily oral PrEP regimen are being explored.
authors: INSERM U941, University of Paris Diderot, Sorbonne Paris Cité, Paris, France. jean-michel.molina@sls.aphp.fr
authors: Jean-Michel
authors: JM
authors: Molina
authors: Claire
authors: C
authors: Pintado
authors: Caroline
authors: C
authors: Gatey
authors: Diane
authors: D
authors: Ponscarme
authors: Pierre
authors: P
authors: Charbonneau
authors: Benedicte
authors: B
authors: Loze
authors: Willy
authors: W
authors: Rozenbaum
authors: Constance
authors: C
authors: Delaugerre
mesh_terms: D000284:Administration, Oral; D000818:Animals; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D002986:Clinical Trials as Topic / Q000639:trends; D005060:Europe / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents
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