Abstract Background: In 2014, approximately 40,000 persons in the United States received a diagnosis of human immunodeficiency virus (HIV) infection.
Pr EP can reduce the risk for HIV infection among HIV-negative persons with sexual or injection exposures from partners who are among the estimated 70% of HIV-infected persons in the United States who are not virally suppressed and are at high risk for transmitting infection (10), including persons with undiagnosed HIV infection, persons with diagnosed infection who are not receiving treatment, and persons receiving treatment who are not virally suppressed.
The combined protective effect of treatment and Pr EP has recently been demonstrated in an open-label study with HIV-discordant couples in Africa (11). Data from national population-based surveys were analyzed to estimate the percentages and numbers of persons with indications for Pr EP in each of three transmission-risk populations: MSM, heterosexually active adults, and persons who inject drugs.
This percentage was weighted as recommended for NHANES data using current population of the population of men aged 18–59 years to yield an estimate of the number of U. The number of persons aged ≥18 years who reported in the National Survey on Drug Use and Health (NSDUH) (having injected any assessed drug during the past 12 months and used a needle that had previously been used by another person was used to yield an estimate of the number of U. persons who inject drugs with indications for Pr EP use.
The estimate for persons who inject drugs did not consider sexual risk or HIV infection status.
Delivering Pr EP in conjunction with other effective prevention services and associated preventive health care (e.g., hepatitis B vaccination and hepatitis B or C treatment when indicated) can be expected to reduce incident HIV infections and other preventable adverse health consequences for persons at risk.
Impact models indicate that 50% coverage and modest adherence to Pr EP by high-risk MSM in the United States could reduce new infections among MSM by 29% over 20 years (12).
The high percentage of MSM with Pr EP indications is consistent with the high number of new HIV infections among MSM.
The high percentage of persons who inject drugs with Pr EP indications reflects the relatively high percentage who report using a needle after it was used by another injector.
Bisexual men were assessed by indications for both MSM and heterosexually active adults and added to the populations for which Pr EP indications were met.