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Tenofovir for Prevention of HIV Infection


Am Fam Physician. 2017 Jul 1;96(1):22A-22B.


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1 in 50 had HIV infection prevented

No one was harmed with serious adverse events

HIV = human immunodeficiency virus.



1 in 50 had HIV infection prevented

No one was harmed with serious adverse events

HIV = human immunodeficiency virus.

Details for This Review

Study Population: Human immunodeficiency virus (HIV)-negative commercial sex workers, men who have sex with men, and individuals with an HIV-positive partner, mostly in developing settings

Efficacy End Points: Incidence of HIV infection; adherence to preexposure prophylaxis (PrEP)

Harm End Points: Adverse events including renal insufficiency, elevated liver enzymes, nausea, dizziness, and vomiting

Narrative: HIV infection occurs in 2.7 million persons each year globally. There remains a need for effective prevention strategies. In 2012, the U.S. Food and Drug Administration approved tenofovir/emtricitabine (Truvada) in the United States for PrEP in conjunction with safer sex practices to reduce the risk of HIV transmission. Nonetheless, research into PrEP has stirred controversy because of concerns about perpetuating risky sexual behaviors, long-term medication effects, and creating drug-resistant strains of HIV from poor compliance.

This Cochrane review reports on the results of six trials examining prevention of HIV infection in persons at high risk.1 This review concluded that compared with placebo, tenofovir/emtricitabine (n = 8,918; relative risk [RR] = 0.5; 95% confidence interval [CI], 0.3 to 0.9) and tenofovir alone (n = 4,027; RR = 0.33; 95% CI, 0.2 to 0.6) both significantly reduced the risk of HIV infection. Moreover, serious adverse events were similar for patients in the PrEP and placebo groups, although minor adverse events such as nausea and vomiting were significantly more common in those receiving m

Author disclosure: No relevant financial affiliations.


show all references

1. Okwundu CI, Uthman OA, Okoromah CA. Antiretroviral pre-exposure prophylaxis (PrEP) for preventing HIV in high-risk individuals. Cochrane Database Syst Rev. 2012;(7):CD007189....

2. Thigpen MC, Kebaabetswe PM, Paxton LA, et al.; TDF2 Study Group. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–434.

3. Baeten JM, Donnell D, Ndase P, et al.; Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.

4. Grant RM, Lama JR, Anderson PL, et al.; iPrEx Study Team. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–2599.

Copyright 2017 The NNT Group. Used with permission.

This series is coordinated by Dean A. Seehusen, MD, MPH, AFP Contributing Editor, and Daniel Runde, MD, from the NNT Group.

A collection of Medicine by the Numbers published in AFP is available at



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