European Journal of Biomedical and Pharmaceutical Sciences

PREVENTION STRATEGIES FOR HIV: A REVIEW OF PRE-EXPOSURE AND POST-EXPOSURE PROPHYLAXIS

Satyanarayana S. V. Padi* and Mohammad Zaidul Raheman

ABSTRACT

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) continue to pose significant global health challenges, despite advancements in antiretroviral therapy that have reduced HIV-related morbidity and mortality. Preventive strategies such as Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) have emerged as essential tools in reducing new HIV infections. This review summarizes current evidence, guidelines, and clinical applications of PrEP and PEP. PrEP involves the use of antiretroviral drugs by HIV-negative individuals prior to potential exposure, primarily using a daily oral combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), which has demonstrated over 99% efficacy in men who have sex with men and up to 84% in people who inject drugs. The introduction of long-acting injectable PrEP, such as Cabotegravir administered every eight weeks, provides a convenient alternative to daily regimens and improves adherence. On-demand (event-driven) PrEP and emerging formulations like vaginal rings and implants also expand prevention options. PEP, designed for use after potential exposure, is most effective when initiated within 72 hours and taken for 28 days. Recommended regimens include tenofovir disoproxil fumarate (TDF) with lamivudine or emtricitabine (FTC), plus a third agent such as dolutegravir or raltegravir, with alternatives for specific populations including children and pregnant women. PEP is indicated following occupational exposure, sexual assault, or high-risk contact with HIV-positive sources. While both PrEP and PEP are highly effective, challenges remain in global implementation due to issues related to awareness, adherence, access, and stigma. Expanding the availability and uptake of these prophylactic strategies, particularly in high-risk and underserved populations, is essential to achieving the global targets for HIV prevention and ultimately controlling the epidemic.

Keywords: Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), Pre-exposure Prophylaxis (PrEP), Post-exposure Prophylaxis (PEP), Event-Driven PrEP.