Post-exposure prophylaxis to prevent HIV: new drugs, new approaches, and more questions

Lancet HIV. 2023 Dec;10(12):e816-e824. doi: 10.1016/S2352-3018(23)00238-2. Epub 2023 Nov 9.


Post-exposure prophylaxis (PEP) to prevent HIV acquisition has been recommended for over three decades, but remains underutilised. Over the past decade, clinical trials have established the safety and tolerability of newer PEP regimens, particularly those containing integrase strand transfer inhibitors (INSTIs) combined with a tenofovir and lamivudine or emtricitabine backbone. Several of these regimens were better tolerated than historical controls. Studies in macaques found that shorter courses of PEP with INSTIs were effective, particularly if dosing occurred close to the time of retroviral exposure. Despite the increase in well tolerated options, PEP seems to be underused globally and links to other prevention services are suboptimal. Interventions to increase provider and community awareness of PEP are needed.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents*
  • Emtricitabine / therapeutic use
  • HIV Infections* / drug therapy
  • HIV Infections* / prevention & control
  • Humans
  • Post-Exposure Prophylaxis
  • Pre-Exposure Prophylaxis*
  • Tenofovir / therapeutic use


  • Anti-HIV Agents
  • Tenofovir
  • Emtricitabine