PrEP plays a fundamental role in helping to prevent new HIV diagnoses, but is underutilized1,2
PrEP is highly effective for preventing HIV1
According to the CDC, PrEP (pre-exposure prophylaxis) can reduce the chance of contracting HIV from sex by ~99% when taken as prescribed.
After 40 years of progress in reducing new HIV diagnoses, HIV remains a public health focus3
Only
36%
of the 1.2M people indicated for PrEP in 2022
were prescribed a PrEP medication2
(CDC, 2022 US estimates for individuals aged ≥16 years)
Groups most impacted by HIV continue to have low rates of PrEP use1,3,4
Disparity by:
Black and Latinx/o MSM
Higher lifetime risk of HIV diagnosis
1in3
Black MSM
vs 1 in 15 White MSM5
Higher lifetime risk of HIV diagnosis
1in5
Latinx/o MSM
vs 1 in 15 White MSM5
(Singh S, et al; CROI 2024. Based on CDC estimates established from HIV diagnosis and death rates; 2017-2021)
In a 2012-2021 retrospective claims analysis of PrEP prescriptions, Black and Latinx/o people were disproportionately underprescribed PrEP relative to their need for HIV prevention.4
*PNR is defined as the number of PrEP users divided by the number of new HIV diagnoses. It is a measurement for whether PrEP use appropriately reflects the need for HIV prevention. A lower PrEP-to-need ratio indicates more unmet need. PNR is derived from pharmacy commercial data (IMS Health, Quintiles, and VIA [IQVIA]; Durham, North Carolina).4,6
Actor portrayals.
Young MSM
Young MSM aged 13 to 34 accounted for
63%
of HIV diagnoses
in 20227
(Based on CDC estimates established from HIV diagnosis rates; N=25,294)
Of 680,970 individuals aged 16 to 34 indicated for PrEP
34%
were prescribed
a PrEP medication
in 20222
(CDC, 2022 estimates for individuals who were PrEP eligible)
In 2023, adolescents and young adults had the greatest unmet need for PrEP among all age groups.6
*PNR is defined as the number of PrEP users divided by the number of new HIV diagnoses. It is a measurement for whether PrEP use appropriately reflects the need for HIV prevention. A lower PrEP-to-need ratio indicates more unmet need.6
Actor portrayals.
Transgender women (TGW)
A meta-analysis of 98 studies showed:
TGW are 66x
more likely to be living with HIV
vs other individuals (aged >15 years)9
(Stutterheim SE, et al; 2021; N=48,604)
A 2019-2020 study showed low PrEP uptake:
32%
of HIV-negative
TGW
(n=288/902)
were on a PrEP medication10*
(CDC, National HIV Behavioral Surveillance report in 7 US cities)
*Took PrEP at any point in the 12 months before the interview to reduce the risk of getting HIV.10
Despite high awareness of PrEP, many TGW are concerned about PrEP interactions with gender-affirming hormone therapy (GAHT)10,11
In pharmacokinetic studies, there were
no clinically significant drug interactions impacting the levels of oral PrEP or GAHT when coadministered12-14
Consider BMD when choosing or prescribing PrEP
High prevalence of low bone mass
was observed in studies of TGW prior to/during GAHT, when compared with men as a reference point, according to DHHS15
In a 2020 Italian cross-sectional study that evaluated fracture risk in 57 TGW on estrogen replacement therapy after gender-confirming surgery
1 out of 7
showed an intermediate-high 10-year fracture risk11,16†
†Participants (≥18 years old) were recruited from Turin, Italy, from January 2012 to May 2018.16
Actor portrayals.
See other considerations for TGWCloseKeep groups most impacted by HIV top of mind for HIV prevention conversations.
BMD=bone mineral density; CDC=Centers for Disease Control and Prevention; CROI=Conference on Retroviruses and Opportunistic Infections; DHHS=US Department of Health and Human Services; GAHT=gender-affirming hormone therapy; IQVIA=IMS Health, Quintiles, and VIA; MSM=men who have sex with men; PNR=PrEP-to-need ratio; TGW=transgender women (who have sex with men).
