Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
Trends in Persons Prescribed HIV Postexposure Prophylaxis in the United States, 2015-2023.
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Le John N, Zhu Weiming, Huang Ya-Lin A, Wei Wei, O'Shea Jesse, Mann Laura M, Tanner Mary R, Kourtis Athena P, Hoover Karen W
Аннотация
BACKGROUND: HIV postexposure prophylaxis (PEP) is the only intervention for reducing HIV acquisition risk after exposure. Our objective was to describe PEP user characteristics and analyze national trends in PEP regimens recommended by the Centers for Disease Control and Prevention (CDC) in 2016 and of off-label bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) for PEP.
METHODS: We analyzed the IQVIA Real World Data-Longitudinal Prescriptions database to identify persons aged ≥16 years prescribed antiretroviral (ARV) PEP regimens recommended by CDC or BIC/FTC/TAF from 2015 to 2023. We excluded persons with an HIV diagnosis or prescribed ARVs for HIV or hepatitis B virus treatment. Two clinicians reviewed regimens to confirm probable PEP prescriptions. We reported an annual number of PEP users, stratified by demographic characteristics, regimen type, and days of supply.
RESULTS: The number of persons prescribed PEP increased from 20 618 in 2015 to 44 934 in 2023. The number of persons prescribed a bictegravir-based PEP regimen increased from 1377 (4.1% of total PEP users) in 2018 to 7536 (16.8%) in 2023. Among 44 934 PEP users in 2023, 53.8% were men, and 39.8% were aged 25-34 years. Most (88.4%) PEP users were prescribed a full course of PEP (28-30-day supply).
CONCLUSIONS: Our analysis found an increasing trend in PEP use annually, possibly reflecting greater PEP awareness and broader HIV prevention efforts. Increased use of a bictegravir-based PEP regimen in 2023 suggests a shift in PEP prescribing practices, likely due to its once-daily dosing and high tolerability. Our findings can guide future recommendations for PEP medications.
METHODS: We analyzed the IQVIA Real World Data-Longitudinal Prescriptions database to identify persons aged ≥16 years prescribed antiretroviral (ARV) PEP regimens recommended by CDC or BIC/FTC/TAF from 2015 to 2023. We excluded persons with an HIV diagnosis or prescribed ARVs for HIV or hepatitis B virus treatment. Two clinicians reviewed regimens to confirm probable PEP prescriptions. We reported an annual number of PEP users, stratified by demographic characteristics, regimen type, and days of supply.
RESULTS: The number of persons prescribed PEP increased from 20 618 in 2015 to 44 934 in 2023. The number of persons prescribed a bictegravir-based PEP regimen increased from 1377 (4.1% of total PEP users) in 2018 to 7536 (16.8%) in 2023. Among 44 934 PEP users in 2023, 53.8% were men, and 39.8% were aged 25-34 years. Most (88.4%) PEP users were prescribed a full course of PEP (28-30-day supply).
CONCLUSIONS: Our analysis found an increasing trend in PEP use annually, possibly reflecting greater PEP awareness and broader HIV prevention efforts. Increased use of a bictegravir-based PEP regimen in 2023 suggests a shift in PEP prescribing practices, likely due to its once-daily dosing and high tolerability. Our findings can guide future recommendations for PEP medications.