The European Centre for Disease Prevention and Control (ECDC) has stated that the agency is not ready to issue a recommendation about the use of pre-exposure prophylaxis (PrEP) to prevent HIV in Europe, aidsmap reports. Its conservative approach to PrEP results from outstanding questions about efficacy, cost-effectiveness, side effects, drug resistance and whether PrEP will lead to a drop in condom use.

The ECDC has stated that the PrEP strategy “merits some mention” and “shows promising prospects for inclusion in the ‘HIV prevention toolbox’ in Europe.” Acknowledging encouraging results in recent research of Truvada (tenofovir/emtricitabine) as PrEP, the agency cites an array of outstanding questions including:

Cost-effectiveness—which is likely predicated upon high adherence rates—as well as affordability.

Whether it is justifiable to provide antiretrovirals to people who do not have HIV while not all those who are living with the virus and who need treatment have received it.
Whether PrEP will divert funds from other HIV prevention efforts.

How to determine who will be eligible, taking into consideration the high cost.
How to encourage maximum adherence.

Whether PrEP will lead to a drop in condom use and how such a shift may affect overall HIV transmission risks.

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