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 The most basic question to ask is "What is HIV pre-exposure prophylaxis (PrEP)?"
Pre-exposure prophylaxis is any treatment you take to prevent catching a disease before you get exposure to it. So, you take this treatment to prevent catching an HIV infection, before you get exposure to the virus. This treatment protocol uses antiretroviral drugs used in treating HIV infections. The drugs that researchers are testing are tenofovir and emtricitabine in a combined tablet. Studies, done in animal models, demonstrated that this combination was very effective for preventing infection. A huuman trial performed last year also demonstrated that this combination was able to cut down on potential infections. The average reduction was 42 percent (range: 15 to 65 percent according to cases).

What is required for HIV pre-exposure prophylaxis (PrEP) to work effectively?
One difference between the animal and human studies is the fact that human beings are not in cages and closely monitored. The human trials involve giving the medications to high-risk groups and having them report for testing every few weeks. Test subjects who stuck with the drug protocol closely had more protection than those that did not follow the protocol closely. So, in order for this to work, those taking the drugs must closely follow protocols in order to get the most effect from it. They were also advised to systematically use condoms, and these prevention measures were assessed and repeated at each protocol visit.

Which groups would benefit from HIV pre-exposure prophylaxis (PrEP)?
The safest method for preventing transmission of the HIV virus involves not having unprotected sex or not sharing used drug needles. The pre-exposure prophylaxis can be seen as an additional measure of prevention. Some have suggested it would work for couples who want to conceive children when one partner is HIV positive and the other one is not. Another use would be among women who have no option on insisting their partners use condoms. Because the PrEP is not 100% effective, this should be a secondary prevention measure.

What are common concerns about the use of HIV pre-exposure prophylaxis (PrEP)?
In the US, AIDS organizations have expressed concerns that using PrEP would potentially give a false sense of safety. This might lead to lower usage of condoms among high-risk populations. Another concern raised is the fact that using the drug before an infection would build up drug resistance in case of infection in the future. There are ethical concerns about how the drug testing goes on among high-risk populations. These concerns include the use of a placebo with a deadly disease and the lack of counseling trial patients receive in some locations.

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