Q: Is event-driven PrEP dosing for HIV as effective as daily dosing?
Abstract
Evidence based answer: PROBABLY, although there are no head-to-head trials comparing the 2 dosing regimens. Event-driven pre-exposure prophylaxis (PrEP) dosing reduces HIV conversion by 86% compared to placebo (strength of recommendation [SOR]: B, large randomized controlled trial [RCT]). Daily PrEP reduces HIV conversion by 44% to 86% (SOR: B, based on open-label RCTs). Event-driven PrEP regimens may be associated with lower adherence when compared with daily PrEP regimens (average of 70% for event-driven PrEP vs average of 92% for daily PrEP) (SOR: B, based on open-label and cohort trials). Event-driven PrEP regimens have lower medication costs, and they are associated with no difference in the rate of sexually transmitted infections (STIs) (SOR: B, based on prospective cohort studies). Patients may prefer them to daily regimens (75% choose event-driven PrEP vs 25% choose daily PrEP) (SOR: B, based on the preponderance of prospective cohort studies with conflicting results).
Citation
J Fam Pract. 2021 June;70(5):253-255 | doi: 10.12788/jfp.0207
Rights
OpenAccess.
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