Transcription
BHIVA/BASHH guidelines on the use ofHIV pre-exposure prophylaxis (PrEP)2018Guideline writing groupMichael Brady (Co-chair) Consultant in Sexual Health and HIV, King’s College Hospital, LondonAlison Rodger (Co-chair) Reader and Honorary Consultant Infectious Diseases and HIV, University CollegeLondonDavid AsboeConsultant HIV and Sexual Health, Chelsea and Westminster Hospital NHS FoundationTrust, LondonValentina CambianoLecturer in Infectious Disease Modelling and Biostatistics, University College LondonDan ClutterbuckConsultant HIV and Sexual Health, NHS Lothian,Monica DesaiConsultant Epidemiologist, Public Health EnglandNigel FieldSenior Lecturer, Consultant Clinical Epidemiologist, University College LondonJustin HarbottleProgramme Officer, Terrence Higgins Trust, LondonZahra JamalPolicy and Research Officer, NAZ, LondonSheena McCormackProfessor of Clinical Epidemiology, MRC Clinical Trials Unit at University CollegeLondonAdrian PalfreemanConsultant HIV and Sexual Health, University Hospitals of Leicester NHS TrustMags PortmanConsultant HIV and Sexual Health, Mortimer Market Centre, LondonKillian QuinnConsultant HIV and Sexual Health, King’s College Hospital, LondonMelinda Tenant-Flowers Retired Consultant in HIV and Sexual Health Medicine, King’s College Hospital, LondonEd WilkinsConsultant in Infectious Diseases, North Manchester General HospitalIngrid YoungChancellor's Fellow, Usher Institute, University of Edinburgh
BHIVA/BASHH guidelines on the use of PrEPContents1 Objectives . 61.1 Inclusivity . 62 Methods . 72.1 Search strategy . 72.2 GRADE system . 72.2.1 Good practice points . 82.3 Stakeholder involvement, piloting and feedback. 82.4 Generic preparations of tenofovir disoproxil . 82.5 References . 83 Summary of recommendations . 94 Evidence for safety and efficacy in key populations . 154.1 Evidence for safety and efficacy in men who have sex with men (MSM) . 154.1.1 Efficacy . 154.1.2 Adherence in MSM populations . 174.1.3 Safety . 184.1.4 Risk behaviour/STIs in MSM . 204.1.5 References . 214.2 Evidence for safety and efficacy in heterosexual populations . 244.2.1 Efficacy . 244.2.2 Adherence in heterosexual populations . 274.2.3 Safety . 294.2.4 Risk behaviour/STIs . 314.2.5 References . 314.3 Evidence for safety and efficacy in people who inject drugs (PWID) . 354.3.1 Efficacy . 354.3.2 Adherence . 364.3.3 Safety . 364.3.4 Risk behaviour . 364.3.5 References . 374.4 Evidence for safety and efficacy in trans people . 384.4.1 Efficacy in trans women . 384.4.2 Safety in trans women . 394.4.3 Trans men . 404.4.4 References . 414.5 Evidence for safety and efficacy in young people (15–25 years) . 424.5.1 Efficacy . 424.5.2 Adherence . 424.5.3 Safety . 434.5.4 Risk behaviour . 444.5.5 References . 454.6 Evidence for the timelines for starting and stopping PrEP. 472
BHIVA/BASHH guidelines on the use of PrEP4.6.1 Blood PBMCs . 474.6.2 Female and male genital tract . 484.6.3 Rectal tissues . 494.6.4 Duration of PrEP use following last possible exposure . 504.6.5 References . 515 Baseline risk-assessment . 525.1 How to identify those at risk of HIV . 525.2 Associations with HIV transmission in UK populations . 535.2.1 MSM and trans women . 535.2.2 Heterosexual men and women . 545.2.3 People who use recreational drugs or people who inject drugs . 555.2.4 People with HIV-positive partners whose viral loads are not suppressed on therapy. 555.2.5 Vulnerability factors in trans people . 555.2.6 Sexual health autonomy and sexual networks . 565.2.7 Risk assessment (Table 5.2.2, proforma and Appendix 2) . 565.3 References . 576 Initiating PrEP . 596.1 Overview . 596.2 Education, behavioural support and adherence . 596.2.1 Education . 596.2.2 Behavioural support . 606.2.3 Adherence . 606.2.4 References . 616.3 Settings and context to administer PrEP . 636.3.1 References . 646.4 Baseline assessment and testing . 656.4.1 Assessment for consideration of post-exposure prophylaxis following sexual exposure (PEPSE) . 656.4.2 HIV testing . 656.4.3 Acute HIV infection. 656.4.4 Assessment of renal function . 656.4.5 STI screen . 666.4.6. Assessment of viral hepatitis status . 666.4.7 References . 686.5 Other considerations. 706.5.1 Women who are pregnant or trying to conceive .
Ingrid Young Chancellor's Fellow, Usher Institute, University of Edinburgh BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP) 2018 . BHIVA/BASHH guidelines on the use of PrEP 2 Contents 1 Objectives .6 1.1 Inclusivity . 6 2 Methods.7 2.1 Search strategy. 7 2.2 GRADE system. 7 2.2.1 Good practice points . 8 2.3 Stakeholder involvement, piloting and .
