Many steps are required between first identifying men who have sex with men (MSM) who are at high risk of HIV and ultimately ensuring they are prescribed and adhere to Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP), Healio reports. Researchers have devised a PrEP “care continuum,” modeled after the continuum that has been established with regards to HIV treatment—a concept that has revolutionized the way public health officials perceive the nation’s challenges when it comes to getting HIV-positive people tested, linked to medical care, retained in care, on treatment, and to an undetectable viral load.

Researchers published their findings in Clinical Infectious Diseases.

They identified five steps in the PrEP care continuum: 1) Identifying MSM who are at risk of HIV; 2) Improving awareness of PrEP as well as willingness to take Truvada among those at risk; 3) Ensuring access to health care, since quarterly clinic visits are required for a PrEP prescription; 4) Ensuring that an individual’s physician is willing to prescribe PrEP; and 5) Stressing the importance of adherence to the daily drug regimen.

Examining data on a cohort of MSM in Atlanta, where MSM, especially young black men, have a markedly high rate of HIV infection, researchers estimated that the PrEP continuum’s status quo could ultimately achieve a 15 percent HIV protection from PrEP. They projected that a 20 percent improvement at each step in the continuum would increase the total potential for PrEP coverage to 44 percent of the local MSM population. Other research has estimated that such coverage would prevent one in four new infections in the overall MSM cohort over a 10-year period.

The investigators conclude that new efforts are needed to facilitate progress through each step in the PrEP continuum, for example, by offering free of low-cost access to PrEP programs among high-risk groups.

To read the study abstract, click here.