By: Stefan D. Barala, Susanne Stromdahla, and Chris Beyrera
Purpose of review
Oral preexposure prophylaxis (PrEP) has shown HIV preventive efficacy for several key populations at risk
for HIV infection including MSM and heterosexual men and women in HIV serodiscordant relationships.
An efficacy trial of daily oral tenofovir among people who inject drugs (IDU) is underway in Thailand.
Recent findings
Although efficacy data is pending, there is emerging biological and public health plausibility data
suggesting the utility of PrEP as an effective component of combination HIV prevention for IDU. Drawing
from studies characterizing adherence to antiretroviral therapy for IDU, there are a range of scientific and
operational considerations for the potential use of PrEP for IDU. We review here the available literature on
the potential use of PrEP for IDU, barriers to uptake and adherence, and potential implementation science
questions, which could address, and potently increase, the effectiveness of this intervention.
Summary
IDU remain the most underserved population in the HIV response worldwide, and have a marked gap in
prevention services, making PrEP a potentially promising addition to the prevention toolkit for people
who use drugs and, for those already living with HIV infection, for their spouses and other sexual partners.
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