CCO Infectious Disease Podcast

PrEP Initiation: Answering the Questions

Episode Summary

Hear from Drs Linda-Gail Bekker and Meredith Clement as they discuss questions about PrEP initiation, including how to start the conversation, who is eligible, practicalities of starting, future directions, and more.

Episode Notes

In this episode, Linda-Gail Bekker, MBChB, DTM&H, DCH, FCP(SA), PhD, and Meredith Clement, MD, discuss PrEP initiation, including:

• The importance of taking a sexual history and getting to know your patient
• Recommendations for who should be considered for PrEP
• Practicalities of PrEP initiation including laboratory assessments, interview and physical exam, evaluating concomitant medications, counseling, and prescribing
• Summary of PrEP eligibility by regimen
• Review of the clinical trial and real-world data for each PrEP modality
• The likelihood of cross-resistance between PrEP options and ART options if someone were to become infected with HIV while receiving PrEP
• Time to effective concentrations of PrEP after initiation
• Whether there are data for on-demand dosing of FTC/TAF
• Recommendations for FTC/TDF on demand for heterosexual cisgender men
• Individualizing PrEP for each person to increase the likelihood of adherence, persistence, and efficacy
• Recommendations for the use of LA CAB for PrEP during pregnancy and in people of childbearing potential
• STI and point-of-care testing for people receiving PrEP
• The possibility of implantable PrEP in the future

Presenters:

Linda-Gail Bekker, MBChB, DTM&H, DCH, FCP(SA), PhD
Professor and Director
The Desmond Tutu HIV Centre University of Cape Town
Cape Town, South Africa

Meredith Clement, MD 
Assistant Professor
Section of Infectious Diseases
Louisiana State University Health Sciences Center
University Medical Center
New Orleans, Louisiana 

Link to full program:
https://bit.ly/3HPu4Lk