An influential task force for the first time is recommending that doctors offer pre-exposure prophylaxis, or PrEP, to their patients at risk of contracting HIV. Currently, the only form of PrEP approved by the Food and Drug Administration is the daily tablet Truvada.

The U.S. Preventive Services Task Force (USPSTF) issued a draft of its recommendation statement that’s available for public comment until December 26. You can read it here. The draft statement gives PrEP an A grade.

If the draft recommendation is approved, according to the New York Times, access to PrEP will significantly improve because the Affordable Care Act (ACA, or Obamacare) requires most health insurers to cover the full cost of preventive services recommended by the USPSTF.

“This is definitely fantastic news and validates everything science has been saying all along,” Aaron Lord, MD, of New York University School of Medicine, told the newspaper. “We’ve known this is a very effective medication for quite a while and feel we could be a lot further along in using it to reduce infections. The potential is absolutely tremendous.”

Lord cofounded a group called the PrEP4All Collaboration, with the goal of increasing access to PrEP—without insurance, the daily regimen can cost up to $20,000 a year.

“PrEP is currently not used in many persons at high risk of HIV infection,” the USPSTF writes in its draft statement. “The [Centers for Disease Control and Prevention, CDC] estimates that approximately 1.2 million persons were eligible for PrEP in 2015 (492,000 men who sex with men, 115,000 persons who inject drugs, and 624,000 heterosexual adults) and an estimated 78,360 persons used PrEP in 2016.”

The USPSTF writes in its draft that the task force “found convincing evidence that PrEP is of substantial benefit in decreasing the risk of HIV infection in persons at high risk of HIV infection, either via sexual acquisition or through injection drug use. The USPSTF also found convincing evidence that adherence to PrEP is highly correlated with its efficacy in preventing the acquisition of HIV infection.” What’s more, “USPSTF found adequate evidence that PrEP is associated with small harms, including renal and gastrointestinal adverse effects.… The USPSTF concludes with high certainty that there is a substantial net benefit from the use of PrEP to reduce the risk of acquisition of HIV infection in persons at high risk of HIV infection.”

  1. Men who have sex with men, are sexually active and have one of the following characteristics:
    • A serodiscordant sex partner (i.e., a sex partner living with HIV)
    • A recent sexually transmitted infection (STI) with syphilis, gonorrhea or chlamydia
    • Inconsistent use of condoms during receptive or insertive anal sex
  2. Heterosexual women and men who are sexually active and have one of the following characteristics:
    • A serodiscordant sex partner (i.e., a sex partner living with HIV)
    • Inconsistent use of condoms during sex with a partner whose HIV status is unknown and who is at high risk (e.g., a person who injects drugs or a bisexual partner)
    • A recent STI with syphilis or gonorrhea
  3. Persons who inject drugs and have one of the following characteristics:
    • Share drug injection equipment
    • Are at risk of sexual acquisition of HIV (see above)

The task force notes that the criteria above apply to transgender men and women, who may be at increased risk for HIV as well as to people who engage in sex work.

To learn more about PrEP, read the POZ Basics on HIV Prevention.

And for a collection of POZ articles on the topic, click #PrEP, where you’ll find a feature about the PrEP4All Collaboration titled “Here’s How We Can Get Universal Access to PrEP.”

Note: An earlier version of this article incorrectly stated the USPSTF is a federal task force; it is not.