March 20, 2025

Trends in HIV Postexposure Prophylaxis Regimens �� United States, 2015�C2023

Presentation Day/Time: Wednesday, April 23, 9:00–10:25 am
Presenter: John Le, PharmD, EIS officer assigned to the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV Prevention

What did we do?

Postexposure prophylaxis (PEP) is critical for HIV prevention because it is the only intervention that can prevent HIV acquisition following exposure but lacks formal surveillance . The 2016 CDC PEP guidelines recommend specific antiretroviral (ARV) regimens. We analyzed national trends in prescriptions of CDC-recommended regimens and bictegravir, a second-generation integrase inhibitor, for PEP and described user characteristics.

The annual number of persons prescribed any PEP increased from 38,059 in 2015 to 49,525 in 2023.
The number of persons prescribed bictegravir for PEP increased from 3,525 (7.3%) in 2018 to 15,048 (30.4%) in 2023.
While CDC-recommended PEP regimens were prescribed equally for men (50.7%) and for women (49.1%), bictegravir was prescribed predominantly for men (72.9%).

Prescriptions of bictegravir for PEP have increased, likely because of its one pill daily dosing, tolerability, and efficacy. Prescriptions may be lower among women due to limited pregnancy drug safety data.
These findings highlight shifts in clinical practice and also the need for updated guidelines, expanded provider education, and a national surveillance system to monitor use of this important tool that needs to be further integrated into HIV prevention strategies.

***This presentation has updated data that will be shared at the EIS Conference.