How Providers Can Help Prevent PrEP Resistance

Segment Description: Kavita Misra, PhD, MPH, senior epidemiologist at the New York City Department of Health and Mental Hygiene, explains how health care providers can help prevent PrEP resistance from growing by increasing screening for acute HIV infection.

Interview transcript (modified slightly for readability):

Contagion®: What can providers do to avoid contributing to the induction of drug resistance?

Dr. Misra: "Based specifically on this analysis, I think the primary takeaway is really that, given that this analysis was done on data from 2015 to 2017 and these are still considered early enough in in in the PrEP years, we should see an increase in more rigorous HIV screening. I think really the takeaway is that PrEP is a good thing; it's powerful prevention modality and under no circumstances should these data suggest that we should become more circumspect about PrEP. Rather, we need to ensure that providers are able to screen people with a more fine-toothed comb to eliminate the possibility that they may be acutely infected when they're initiated on PrEP, and then once they're on PrEP to continue this rigorous monitoring to make sure that if they happen to be initiated on PrEP while infected that they can be then transitioned to the appropriate drug regimen as promptly as possible to reduce the amount of time on monotherapy."

The study, “Impact of PrEP on Drug Resistance and Acute HIV Infection, New York City, 2015-2017,” was presented on Wednesday, March 6, 2019, at CROI 2019 in Seattle, Washington.