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GeSIDA presents an update of its recommendations document on PrEP and suggests to facilitate prophylaxis to anyone who can benefit from it and to make its therapeutic follow-up more flexible. It also proposes making therapeutic monitoring more flexible and adapting it to the characteristics of each user , in which primary care and nursing staff, among others, could also participate. The first edition of this document - indicating the feasibility of implementing PrEP in Spain - was published in , although it was not until that this prevention strategy was included in the National Health System's service portfolio. The initial indication targeted men who have sex with men MSM , transgender women and sex workers, while in it was extended to adolescents from the age of 16, people who inject drugs, and cisgender men and women at risk of acquiring HIV. Although in recent years there has been a reduction in the number of new HIV infections, especially among MSM - helped by the implementation of PrEP - there are still a significant number of infections that could be avoided with an optimal implementation of this prevention strategy, which has already shown great preventive efficacy, safety and cost-effectiveness in different population groups, always under the condition of proper adherence. In mid there were 13, people on PrEP in Spain , almost all of whom were MSM, which was less than the estimated number of candidates eligible for this prevention measure. Therefore, the main challenge now is to remove barriers to accessing PrEP programmes and to scale up their implementation across the country. For this reason, the AIDS Study Group is now considering providing this preventive treatment to people who have been diagnosed with hepatitis C, to partners of people with HIV who are not undetectable because they are not on antiretroviral treatment or have recently started it and to people who at the time of the risk assessment do not present any of these criteria, but who express a change of situation in the immediate future, for example, to stop using condoms. In order to facilitate access to PrEP , whose regimen is based on hospital-prescribed drugs, GeSIDA also proposes to bring this treatment from hospital pharmacies to the health care facilities that provide care to these users: STI Sexually Transmitted Infection clinics or other out-of-hospital centres , such as primary care centres or community centres. PrEP should be prescribed and supervised by a health care provider who is experienced in the management of HIV and STIs, and who is also trained in cultural competencies for the care of sexual minorities. Pharmacy depots, dependent on the Hospital Pharmacy services, may be an appropriate formula for facilitating access to treatment, also contemplating telematic monitoring carried out through telepharmacy programmes. The role of specialised nurses is fundamental and they could be responsible for the follow-up of non-complex users. For this proposal to be possible, hospital and outpatient units must be provided with sufficient staff and resources to be able to adequately meet the demand and care of PrEP users. The results of scientific studies show some discordance regarding the possible increased incidence of STIs in PrEP users. However, PrEP is part of a programme that also includes a combination of measures such as condom promotion, sex education and counselling, substance use assessment, early detection and treatment of STIs, and updating of vaccination status. Therefore, the GeSIDA document recommends screening for syphilis, chlamydia and gonorrhoea every three to six months, depending on each person's risk, as well as HCV serology or PCR in case of previous positive serology every months, depending on each person's risk. More than 40 years after its emergence, and despite significant advances in diagnosis and, above all, treatment, HIV remains a major public health issue today. In , 1, new HIV diagnoses were reported in Spain , a rate of 4. Despite the progress made in recent years in the field of HIV infection and, consequently, the reduction in the rates of new diagnoses, its elimination is still not effective. Condom promotion, counselling, early diagnosis and treatment, and post-exposure prophylaxis PEP are insufficient to achieve real control of the epidemic. In this context, PrEP has emerged as an additional tool to the measures in use. It is a strategy that is part of the combination prevention of HIV infection recommended by UNAIDS to achieve the proposed targets and to reach the targets of goal 3 of the Sustainable Development Goals by In addition, it has been shown that the set of interventions has a synergistic effect, such that they interact to produce a combined impact that is greater than the sum of their separate effects. In this context, it has been modelled that 'virtual elimination' of HIV transmission in MSM could be achieved in the next two decades, if current measures persist. PrEP is not just about administering the drug, but should be part of a programme that includes individualised preventive counselling, assessment of possible adverse effects, screening for sexually transmitted infections STIs , screening for substance use and updating vaccination. Cohort studies and clinical practice reinforce the safety data for this preventive measure, already observed in clinical trials. Close Search. More beneficiaries Although in recent years there has been a reduction in the number of new HIV infections, especially among MSM - helped by the implementation of PrEP - there are still a significant number of infections that could be avoided with an optimal implementation of this prevention strategy, which has already shown great preventive efficacy, safety and cost-effectiveness in different population groups, always under the condition of proper adherence. Promote close access and monitoring In order to facilitate access to PrEP , whose regimen is based on hospital-prescribed drugs, GeSIDA also proposes to bring this treatment from hospital pharmacies to the health care facilities that provide care to these users: STI Sexually Transmitted Infection clinics or other out-of-hospital centres , such as primary care centres or community centres. The HIV situation in Spain today More than 40 years after its emergence, and despite significant advances in diagnosis and, above all, treatment, HIV remains a major public health issue today. Not available in. This is not available in. You can go to the translated versions in these languages:.

Stroke genetics informs drug discovery and risk prediction across ancestries

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Roger Paredes, Vincent C. Marconi, Shahin Lockman, Elaine J. The global community has committed itself to eliminating new pediatric HIV infections by and improving maternal, newborn, and child health and survival in the context of HIV. Such objectives require regimens to prevent mother-to-child transmission pMTCT which, while being highly efficacious, protect the efficacy of future first-line antiretroviral therapy ART. This strategy is more likely to achieve sustained undetectable HIV viremia, does not involve ART interruptions, is simpler to implement, and is cost-effective. Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:. Typically, access is provided across an institutional network to a range of IP addresses. 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