Barriers to HIV Pre-exposure Prophylaxis Treatment

Abstract

Globally, the incidence of human immunodeficiency virus (HIV) continues to remain high despite the implementation of numerous research and prevention strategies. The number of new HIV infections in adults worldwide has not declined since 2010 (USAIDS, 2016). While significant progress has been made in the United States since the discovery of HIV/AIDS in 1981, new infection rates continue to remain higher than expected.

According to the Centers for Disease Control and Prevention (CDC) there are approximately 1.2 million people in the United States infected with HIV, with new diagnoses estimated at 39,513 in 2015 (CDC, 2016). Of these cases, homosexual men accounted for 67%, while African American men having sex with men (MSM) disproportionately made up the largest number of new diagnoses compared to other racial or ethnic communities in the United States. Additionally, the report identified African American heterosexual women as an at-risk population. Although the number of new HIV diagnoses among this group declined from 2004 to 2014, African American heterosexual women accounted for a higher proportion of HIV cases compared to other women of other races or ethnicities (CDC, 2016).

While transmission of HIV among high risk populations continues to remain problematic in the United States, the introduction of pre-exposure prophylaxis (PrEP) treatment is one prevention method that both health care providers and individuals at risk should consider. This article will review the current guidelines for prescribing PrEP and explore possible barriers for both provider and patient regarding increased utilization for prevention HIV treatment.