Talk:Pre-exposure prophylaxis for HIV prevention

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): BPerkovich. Peer reviewers: Vhwang8.

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Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 June 2020 and 21 August 2020. Further details are available on the course page. Student editor(s): JuneKimUCSF, DDrucker, RJonesUCSF, L.Sanchez UCSF. Peer reviewers: M.Ocampo, Future UCSF Pharm.D..

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Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Mike513us. Peer reviewers: Jerome.chelliah.

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OUT OF DATE

This entry is surprisingly out of date; PrEP is not longer experimental, having been approved by the FDA in 2012; several studies have further attested to its effectiveness; other studies have shown no increase in risky behavior; but the newest studies cited in the article are well out of date. Can someone help?

Dpmath (talk) 05:41, 24 April 2014 (UTC)

EDITORS: THIS ARTICLE IS ALMOST DANGEROUSLY OUT OF DATE WITH CDC GUIDELINES! CAN SOMEONE TAG IT?

— Preceding unsigned comment added by 70.111.150.118 (talk • contribs) 21:04, 2 September 2014‎

I just updated it a bit. Blue Rasberry (talk) 23:42, 28 December 2014 (UTC)

STILL out of date. No mention of the huge UK proud study. I'm not an expert editor, so I don't know how to flag this deficiency to the relevant people 87.112.140.203 (talk) 11:50, 6 April 2016 (UTC) Oops, Adagio67 (talk) 11:51, 6 April 2016 (UTC)

Use in dentistry

Might be worth noting that this technique is also in use when there is a risk of transmitting a disease during a medical procedure. Specifically, its use in dentistry. Take a look here. Muuon (talk) 08:11, 19 November 2007 (UTC)

What is up with this page?

This article is perplexing.

1. My understanding is that the difference between prophylaxis and vaccines is that vaccines have a lasting effect, whereas prophylaxis is effective only while on treatment. As such, I removed the editorial sentence about a Herpes vaccine being "good news," and the empty HPV section (which I assume was intended to be about Gardasil.)
2. Yes, I suppose anti-malarials are a form of pre-exposure prophylaxis for malaria, but I've never heard them called "PrEP" or "pre-exposure prophylaxis." To my knowledge, PrEP refers exclusively to the use of antiretrovirals prior to HIV exposure, and I am able to find zero references that indicate otherwise. I am tempted to remove every reference to prophylaxis for infections other than HIV from this article unless someone can produce a source indicating that "PrEP for Malaria" is a thing anywhere other than on Wikipedia.
3. The 'criticism' section is... odd. I'm not sure what criticism it was originally intended to discuss (perhaps the mythical Truvada whore?) but in its current form I think it should be killed with fire. What is there to criticize about a drug that prevents AIDS, anyway?

So, yeah. What do you think? betafive 09:42, 14 August 2014 (UTC)

I ran a Google scholar search, "pre-exposure prophylaxis" -hiv, to find papers on pre-exposure prophylaxis for infections other than by HIV. This yielded articles on pre-exposure prophylaxis for numerous diseases including rabies, viral hepatitis, Burkholderia pseudomallei, human papillomavirus, laboratory-acquired leptospirosis, influenza A, and tick-borne encephalitis, as well as for the effects of exposure to ricin and tear gas.

I think the Criticism section is self-explanatory. For one thing, any preventive that has its own risks is subject to criticism (if the vaccine for measles killed one out of every five people to whom it was given, it would be heavily criticized); the research used to support the recommendation of any practice is subject to criticism of its methodology, its execution, and the reasoning used to draw conclusions; the presentation of PrEP for HIV is subject to criticism, as when it gives the impression that it provides greater protection than condoms when used instead of condoms, which may not be true; and so forth.

—Largo Plazo (talk) 10:34, 14 August 2014 (UTC)

Interesting. Two new questions, then:

1. Are any of them referred to as "PrEP," or is that term specific to HIV pre-exposure prophylaxis (as the CDC seems to think)?
2. Did you find any real criticism of PrEP? As it is currently written, the "Criticism of PrEP" section doesn't contain actual criticism, so if that section is appropriate and encyclopedic, it would be helpful to find some to put there. Otherwise, I still think it should be kilt with fire.

betafive 12:09, 14 August 2014 (UTC)

It doesn't matter whether they refer to it as "PrEP". The title of this article is "Pre-exposure prophylaxis".

Most of what's in the Criticism section is criticism. I don't understand where you're coming from on that. Referring to your edit summary, side effects are certainly a legitimate basis for criticism. Did you not get my point about, for example, criticizing a preventive for causing more problems than it prevents like, for example, killing people? —Largo Plazo (talk) 12:25, 14 August 2014 (UTC)

1. Sure it does. "PrEP" is a redirect to this article, the very first sentence says "Pre-exposure prophylaxis (PrEP)...", and, uh, it's in all the section names. If the term "PrEP" is unique to pre HIV exposure prophylaxis, then this article as currently written is misleading.
2. Actually, none of what's in the criticism section is criticism of PrEP. There is a description of the side-effects as minor and transient, there's a criticism of the study participants for failing to comply with their prescribed regimen, there are vague and weasel-worded "concerns" about delivery, and there is the preliminary result of a CDC trial which appears to show that PrEP does not increase the prevalence of risky sex. Your point doesn't make any sense; are you implying that PrEP kills people? That would be a legit criticism of PrEP. We'd need a RS for it, though. betafive 12:49, 14 August 2014 (UTC)

Redirecting from a narrow topic without its own article to an article on an encompassing topic is a common and ordinary occurrence that in no way implies that the general articles are supposed to be restricted in their scope by the narrower scope of the redirected topics. Tergeo redirects to Harry Potter, but surely no one thinks that the scope of Harry Potter should therefore be limited to coverage of the Tergeo spell.

No doubt the article has had both contributors who were unaware of the concept, or at least the term, "pre-exposure prophylaxis" prior to its use for the HIV prevention regimen and are under the impression that the term goes hand-in-hand with HIV; and contributors who know the term as the more general one that it is. I also don't know whether the abbreviation "PrEP" was prevalent before its application to HIV. Therefore, no doubt that the article reflects this confusion. If, in fact, "PrEP" is termed as such only in the context of the HIV prevention protocol, then the article may need some editing to clear away misassociations among things and get everything straightened out.

I didn't say PrEP causes death. But if you agree with the proposition that if death was a common side effect from some preventive treatment it might be the basis for criticism of that treatment, then we can dispense with your dismissive, blanket "side effects aren't criticism" and recognize that a mention of side effects being raised as a cause for concern with this preventive measure fits the definition of the word "criticism". —Largo Plazo (talk) 13:59, 14 August 2014 (UTC)

If "PrEP" is not in common currency to refer to pre-exposure prophylaxis for illnesses other than HIV, the introduction of this article needs to be changed to not imply that the terms are synonymous, and all references to "PrEP for X" where X is not HIV need to be altered to instead say "pre-exposure prophylaxis for X."

Chemotherapy actually can cause death. If you look at Chemotherapy, you'll notice there's no criticism section; it's called "adverse effects." HRT can also cause death. You'll notice that none of the hormone replacement therapy articles have criticism sections. This article should not have such a section either.

Do you agree? betafive 18:20, 15 August 2014 (UTC)

'If "PrEP" is not in common currency to refer to pre-exposure prophylaxis for illnesses other than HIV, the introduction of this article needs to be changed to not imply that the terms are synonymous ....' Yes, that's what I said.

So in another article someone put the same sort of analysis under a different heading. That is immaterial. How is the question of whether a given article should have a section on criticisms to which its topic has been subjected, or the question of whether that section should be called "Criticism", dependent on whether or not some editor has seen fit to create a section with the same heading in any other article you might point to? —Largo Plazo (talk) 18:42, 15 August 2014 (UTC)

"Claritin causes dry mouth" is an adverse effect. "Laetril doesn't work" is a criticism. Does that clear things up? This criticism section isn't critical. betafive 20:51, 15 August 2014 (UTC)

"Claritin may cause fat redistribution, lymphoma, violent dreams, and suicidal thoughts" is a criticism if it's being argued that those side effects are worse than the condition for which Claritin is being advocated. —Largo Plazo (talk) 22:05, 15 August 2014 (UTC)

Wikipedia doesn't argue, it presents information. Are there reliable sources critical of PrEP? If not, the criticism section has no place here. betafive 22:29, 15 August 2014 (UTC)

Nearly everything in the section is sourced and nearly all of it is significant. It is true that some of it is in the form of something one would say to respond to a criticism, and some of implies a possible source of criticism without citing a criticism. So clean-up and reorganization are called for, but not outright obliteration of the content of that section. —Largo Plazo (talk) 22:38, 15 August 2014 (UTC)

Fine, let's do this.

The first full paragraph would do well under the section heading "Adverse effects." None of it is critical of PrEP:

• The PrEP studies have shown the drugs to be safe, with few side effects. is praise, not criticism.
• Generally, minor side effects such as nausea or diarrhea resolve themselves within the first few months.[9] Effects of Truvada on kidney function have been shown to be temporary.[11] The level of effectiveness depends on the degree of adherence to the prescribed regimen. In iPrEx, persons with greater than 90% adherence to the drug had an efficacy of 68% protection versus persons with less than 50% adherence who had an efficacy of 16%. are all facts, not criticism.
• Furthermore, the FEM-PrEP trial that was stopped early due to futility, found that the women's adherence to the drug was too low to find any effect on reducing HIV infections. is a criticism of women's adherence to the study protocol, not of PrEP.

The second paragraph is a transparent contrivance that fails WP:SYNTH:

• Given mounting evidence of the effectiveness of PrEP among different populations when the drug is taken correctly, concern has turned more towards the practicalities of implementing PrEP as prevention. Whose concern? The editorial voice does not express concern.
• Since approximately 60% of people needing anti-retroviral therapy are not getting it, there are concerns that trying to deliver PrEP to many more people would be challenging. What the fuck? That doesn't follow.

Looking at the given source, we see this:

A major issue is how to roll out PrEP programs when there is a global post-infection treatment gap. Currently, we need to expand antiretroviral therapy access to the approximately 60% of HIV-infected individuals who are eligible for treatment but are not receiving it. The challenge of offering PrEP in this context should be reframed away from "prevention versus treatment" to "treatment and prevention, in parallel." To achieve this, we need to reduce antiretroviral therapy delivery costs, address the treatment gap, improve retention in care, and optimize the clinical and public health benefits of antiretroviral therapy. We also need to initiate pilot programs of cost-effective PrEP delivery models and shift prevention resources to fund strategies that actually work.

While that certainly is criticism, it is not critical of PrEP. Rather, it is criticism of our healthcare delivery model, wherein PrEP is suggested as a means of its improvement. Something of a different bias, eh?

Lastly:

• Effects of PrEP on behavioral changes, such as decreased condom use, are currently being studied. The CDC is conducting an extended safety trial in the U.S. to determine if men taking the drug who have sex with men are more likely to engage in risky behaviors; preliminary results do not show any change in behavior. totally fails WP:DUE, to say nothing of the POV-pushing implications.

So, there it is. The section sucks and needs to be killed with fire. I'm sorry you don't like my tone; my heartfelt suggestion is that you get over it. betafive 04:56, 16 August 2014 (UTC)

I do not mind your tone, but critical attitudes sometimes are met with encouragement to write content for an article. Why not add what you want to the article? Blue Rasberry (talk) 12:57, 16 August 2014 (UTC)

Sorry, that comment was in response to Largo's previous edit summary. I'm intending to expand the article, and hopefully split PrEP off from pre-exposure prophylaxis for things other than HIV, but that section needed some heavy copyediting first. betafive 15:53, 16 August 2014 (UTC)

Perhaps this article should only be about HIV

The phrase "pre-exposure prophylaxis" could mean anything, but practically all sources now use this only to refer to preventing HIV. Here are some other prophylaxis articles:

• Malaria prophylaxis
• Antibiotic prophylaxis
• Dental antibiotic prophylaxis
• Dental prophylaxis, which redirects to "Scaling and root planing"

I am not convinced that any of these names are best for these articles, because they could use other names which have clearer meaning than prophylaxis.

I am thinking of making this article entirely about HIV, because even though the term "pre-exposure prophylaxis" was occasionally used historically in other contexts no other use was well-established, and now the use for HIV is international. Blue Rasberry (talk) 21:14, 28 December 2014 (UTC)

I agree that there has to be an article specifically about the use of pre-exposure prophylaxis for HIV prevention. I think it could be called "Pre-exposure prophilaxis", as this article is called now, or "Pre-exposure prophilaxis for HIV prevention". Anyway, the use of medications for HIV prevention definitely deserves its own article. Paulista443 (talk) 00:51, 21 June 2015 (UTC)

It could be handled according to standard Wikipedia disambiguation convention: Pre-exposure prophylaxis (HIV). It's what most people searching for "pre-exposure prophylaxis" will be looking for, but it can be handled with a hatnote at the top of the generic article on the subject. —Largo Plazo (talk) 01:50, 21 June 2015 (UTC)

In a recent edit @The Anome: said, "clarity in the intro -- PrEP isn't necessarily HIV PrEP by definition, but in cmmon practice the term seems to used solely to refer to HIV PrEP". It might not be logical, but I think that "Pre-exposure prophylaxis" is a jargon term that only refers to HIV prevention. It was never popular for other uses and in the English speaking world has recently become popular only for use to talk about HIV.

I would not oppose WP:disambiguation to link to another article on prophylaxis, but I have doubts about saying that "PrEP isn't necessarily HIV PrEP". I think in all publications it is only about HIV. It already is an odd term, because for example malaria prophylaxis is always "malaria pre-exposure prophylaxis" even if the "pre-exposure" part is not stated. The logic for using this weird term was to contrast with the already commonly used term "post-exposure prophylaxis", so using the strange jargon "pre-exposure" means that HIV is the topic. With conditions other than HIV people would usually say "prophylaxis" and not have a special term to describe when the exposure happened, and instead decide the correct treatment without using a particular phrasing.

I could be mistaken, but if someone wants to make a case for "PrEP means something other than HIV" then I would request a source. Blue Rasberry (talk) 17:15, 11 January 2017 (UTC)

I agree with Blue Rasberry. If it turns out the term "pre-exposure prophylaxis" is only ever used in an HIV/AIDS context, then we can get rid of what will then be unnecessary distinction=making in the intro. -- The Anome (talk) 23:52, 11 January 2017 (UTC)

Peer Review

Agreed with your edits to make page more patient-friendly and up-to-date, as well as to remove much extraneous or redundant info. I would consider keeping the intro shorter and expanding on details in the body (ie discuss Truvada, its formula, and how to use it further elsewhere). Some medical jargon still exist on the page (ie serodiscordant can be changed to something like "mixed HIV-status couples"). The current events info (usage, research, etc) is fantastic. Well-done also on keeping the voice neutral. Vhwang8 (talk) 02:58, 12 December 2017 (UTC)

This is a wonderfully succinct and clear article which highlights the main points without being dense. At present, I would not add anything more, however in the future these maybe interesting talking points to add in the articles

1. HIV drug resistance for PreP as a potential issue
2. Optimal route of drug exposure (currently unknown) - vaginal chemoprophylaxis?
3. Does PreP have any effect on decreasing other STI?
4. Whether the concept of "Truvada Whores" continue to hold up as a trend? could be included in the History section
5. What tests need to be done every 3 months besides HIV test? This can be included now

— Preceding unsigned comment added by Jerome.chelliah (talk • contribs) 19:42, 12 November 2015 (UTC)

Research table

This article has a research table which seeks to summarize some research on prep. I am not sure what information should be contained in such a table. There is limited space. Additional information which I would like to see is number of study participants and dates of the study. If any information is added then probably something should be removed. There are not really standards in Wikipedia for deciding what information is most important about clinical trials. Blue Rasberry (talk) 13:19, 6 February 2017 (UTC)

Related article about new prep trial

I started it at HPTN 083. Blue Rasberry (talk) 13:19, 6 February 2017 (UTC)

Medical Student to edit page, would welcome your thoughts on my plan for edits

Hello wikipedians! I'm a medical student currently enrolled in a course structured to allow medical students to update medically relevant wikipedia pages. I have a background in HIV research, particularly in high-risk LGBTQ populations, and am excited to contribute to the page. Below is my timeline for edits and some rough notes about the direction I'd like to take the page. Would love your feedback, as I'm considering several significant changes to the layout and content of the page. All in all, I'd like the page to move away from a more research/provider focus and become a little more patient-friendly.

WORK PLAN OUTLINE

WIP 1 Mon 11/27 Finalized workplan for course Re-review article and compile initial list of tasks Reach out to UCSF experts in PrEP for advice Any changes to guidelines since CDC publication of 2014 clinical guidelines, e.g. from different professional societies? Any further adoption or research to uses of ARVs for PrEP noncontinuously? Or nonorally?

WIP 2 Fri 12/1 1/2 initial round of edits completed and live on page Have completed or scheduled 1-2 informational interviews with experts

WIP 3 Wed 12/6 Completed initial draft of revised page (in preparation for peer review, beginning 12/7) Complete any additional informational interview

WIP 4 Mon 12/11 Complete peer review of classmate’s page Respond to peer’s feedback on page, indicating what feedback will be implemented and why other feedback won’t be incorporated into the final page

WIP 5 Fri 12/15 Final edits due

What to add? Move discussion of availability and pricing to separate “Access” section, beneath medical uses Add information about ways to access PrEP (e.g. Gilead’s copay reimbursement program, Gilead’s free PrEP program, that you need to see a prescribing provider to access PrEP), reframe section as “access” Add section “side effects” beneath new “access” section to describe toxicities Add section for acute HIV infection while on PrEP Under “Medical Use” section, include reference to PrEPWatch.com’s list of national guidelines for PrEP (https://www.prepwatch.org/prep-resources/national-policies-guidelines/) While basing the section on the CDC’s guidelines makes sense to me at this point, there should be at least a reference to where readers can find guidelines from other governments and professional societies Need updated information about the retail cost of PrEP. Currently only lists the retail cost in the UK, which is far less than in the US. There’s press coverage of the cost in the US, including a recent NYT article. Would also be great to include pricing information from different countries. It seems to me we need a section on “effects of PrEP” specifically addressing some of the emerging evidence that PrEP is having a significant effect on the incidence of new HIV infections. What to remove? Intro frames “pre-exposure prophylaxis” as a non-HIV specific issue, which while theoretically correct, is not in line with the way PrEP is used. Just focus the first paragraph on HIV Remove table of specific research studies from “Research” section It makes good sense to me why someone wanting to know more about PrEP would be interested in the research behind the technology, but this section requires constant upkeep to stay up to date and offers much more detail than is necessary for the average reader. It seems like it would primarily be of interest to researchers and clinicians, who have other venues for discussing the ongoing research.

What to trim down/condense coverage of? Intro is overly technical, with lots of medical jargon Consider adding one of the marketing campaign adds for PrEP somewhere on the page Rename “medical guidelines” to “medical uses” Under medical guidelines section, there’s a lot of information about who PrEP might NOT be right for. This information is technical and may be better suited for providers. I’m not sure it needs to be there. I would also add to the medical guidelines section a separate paragraph for the information about the clinical care required to stay on PrEP, including regular lab work, appointments, etc. Politics and Culture section: reframe the “Truvada Whore” sentence as largely a past tense phenomenon. While this was a topic of conversation in cities like NYC/SF (where the media coverage cited is focused on) several years ago, today this is not a term you hear much anymore. Could be reasonable to link to press coverage of the AHF and their opposition to PrEp several years ago.

Citation issues Intro Description of PrEP as the use of drugs to prevent HIV infection: https://www.cdc.gov/hiv/risk/prep/index.html [2] citation in intro is out of date (2011), refers to PrEP as an experimental treatment. Medical Guidelines Only need to cite the block of indications, not every one Side effects discussion includes citation of primary research; CDC guidelines contain sufficient information about side effects and their management to build a better section on toxicities Research Reporting some of the original research that laid the groundwork for PrEP makes some sense, but I think it would need to be restructured with more of a narrative, e.g. here’s the research indicating that this might work, here’s some that showed that it did work, here’s some showing potential future directions. I think this would be strengthed by citing only those primary studies mentioned in the section, and removing references to some of the media coverage of studies. Approval for Use First sentence uses duplicate citation of CDC guidelines. I’m not sure that this first paragraph needs to be here at all. Could start the section with the WHO recommendations, into FDA approval of PrEP Begin with second sentence of second paragraph, which quotes the WHO saying essentially that PrEP works to prevent sexual transmission of HIV across populations Simplify citations of countries in which PrEP has been approved. The official update from Gilead in 2016 (citation 32) is good enough for all the listed countries Remove France as separate entity as it’s a part of the EU, which is also listed Norway is not part of EU, can use separate citation there Israel also requires separate citation Kenya, South Africa, and Taiwan included in Gilead insert Add Peru and Thailand, which are also included in the Gilead insert Questions Adoption map - it’s been put together by a wikipedian, last updated 8/2017, with tons of different sources. I can’t find all the citations mentioned in the map to double check the data. Not sure what to do with this?

BPerkovich (talk) 23:28, 26 November 2017 (UTC)

As a med student who often struggles to stay up to date on the most relevant research for controversial topics like PreP I really like the research table, I really like the columns the writer chose to include and I think it would be worth keeping at least the most important studies on there. I can imagine myself getting asked by a patient about the effectiveness of PreP and it would be so nice to be able to give them something so easy to understand with real hard numbers that might affect decision making for both providers and patients. Is it possible to write the "these are the real landmark studies" narrative as you plan and at the end of that, for readers who want to know just one level deeper (eg a grad student researching his/her doctor's advice) trim down the table to those studies? That's how I as a reader would like use the table, to answer a patient question about what is known about how effective PreP really is with both perfect use and imperfect/real-life-consumer use.

As for the map it's a shame that it's already out of date because it's a really cool widget that they have there. But I do see your point about the questionable utility of keeping something on a Wikipedia page that would require so much upkeep, especially since Wikipedia isn't a news source but an encyclopedia. Perhaps a compromise could be to label the map with the date, "world wide adoption as of December 2017." NewDancinShoes (talk) 17:26, 28 November 2017 (UTC)

Iceland has approved PrEP

Unfortunately I don't have the skills to edit the map, but Iceland has approved PrEP and started distributing it in July this year.

See this link

Argamea (talk) 15:04, 19 September 2018 (UTC)

Adherence

Why is "adherence" a parenthetical after "Number of people who took medication." That seems like a pretty misleading description of adherence. Roboraptor3000 (talk) 16:46, 18 May 2020 (UTC)

The number of patients who actually take a prescribed medication is called "adherence". Ruslik_Zero 19:38, 18 May 2020 (UTC)

Foundations II 2020 Group 23 proposed edits

Add additional drug information to Availability and Pricing that contains content related to nationwide access and availability to getting PrEP (Pharmacist furnishing, truvada, descovy, etc.)
Add information about populations that can benefit from access to PrEP (MSM, people who use drugs, sex workers, etc.)
Add information about how and when to use PrEP (guidelines, clinical practices, how long to take, challenges(?) etc).
Add sections and information about general PrEP practices for the importance of pre-exposure for many other serious conditions (malaria, Hep viruses, HIV, etc.)
Add to Research section information about studies/trials/meta-analyses that relate to newer data (descovy)
Add to politics and culture new information about nationwide programs/initiatives/etc. similar to NY/SF
Change header(s) to reflect culture/politics/etc in the US specifically RJonesUCSF (talk) 20:53, 28 July 2020 (UTC)

Hi there RJonesUCSF and the rest of Group 23. Welcome! A couple of notes as you get started:

1. New messages typically go at the bottom of a talk page. I've moved this one for you. No harm done.
2. Over the years, the community of medical editors has hammered out a list of suggested sections for articles on medical interventions. You can find them here. I often find the list of suggestions helpful to guide my research and writing; perhaps it will help you identify information that is missing.

Other than that, have at it. I'll try to keep an eye on this talk page, so if you have questions as you start editing, feel free to ask here (or find a broader audience at WT:MED). I'm glad to see new editors interested in medicine-related articles! I hope you decide to stick around after your course finishes. Ajpolino (talk) 00:29, 30 July 2020 (UTC)

1. Thank you Ajpolino for this kind welcome! We appreciate your patience as we navigate helping to edit this page and learn how to best use wikipedia. Thank you for these shared resources as well! Looking forward to talking and working with you and all contributors.

RJonesUCSF (talk) 18:50, 30 July 2020 (UTC)

I think we can also talk about healthcare workers at risk for HIV infection, due to needle sticks. DDrucker (talk) 18:44, 30 July 2020 (UTC)

A section over recommended screening and how often it should be done is also needed L.Sanchez UCSF18:58, 30 July 2020 (UTC)

Foundations II 2020 Group 24 Peer Review

Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? Has the group achieved its overall goals for improvement?

Yes, I would say that the group’s edits have improved the article. The sections added under the “Medical Uses” section was an important addition, particularly the paragraph describing the dosing regimen and comparison between PrEP and ED-PrEP. This section definitely achieved the group’s goal to include information about how and when to use PrEP, and the language used was appropriate and easy to understand. They were also careful to not use medical language and did not refer to those taking PrEP as “patients,” which was appropriate. I appreciated the section “Availability and Pricing in the United States,” although I thought that the information added to this section aligned more with your goal for the “Politics and Culture” section, but you got the information into the article and it is definitely a valuable addition. I cannot see any evidence of plagiarism, and the group has included appropriate citations and references throughout the new additions to their article. Gmackey18 (talk) 21:03, 3 August 2020 (UTC)Gmackey18

This group has edited a top importance C level article. Through the suggestion of past editors, they have committed to editing significant portions related to populations, the medications themselves, other relevant conditions through prophylaxis, programs and new data. Sections that view as significantly edited: beginning information related to programs has been added, complications of medication, additional population information related to specific populations, particularly trans individuals, pregnancy, and the elderly- but also cultural implications of populations, and significant citations. Sections potentially needing work: intro is lacking citations, other relevant conditions using prophylaxis. This draft is written in a neutral point of view. No conflicts of language have been found. It is educational, informative, and not conflicting in presentation.Alansfeld (talk) 21:00, 3 August 2020 (UTC)ALandsfeld

Overall, I think edits to the page are very well done with each of your suggestions being addressed in some way. The edit to the introduction has made the beginning of the article more coherent and clear. Availability and pricing information was added in each addition of the edits made by the authors. Population edits were addressed when speaking on 2+1+1 dosing. How it is used and when it is used is addressed through guidelines. Politics and culture is addressed through talks about California’s senate bill. In terms of the edits aligning with the Wikipedia manual of style, references to primary literature is not preferred so the article does fall short in this way; however, again, I thoroughly enjoyed these edits and think it was well edited. --M.Ocampo, Future UCSF Pharm.D. (talk) 21:10, 3 August 2020 (UTC)

Foundations II 2020 Group 24 Peer Review

Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? Has the group achieved its overall goals for improvement? Yes, I would say that the group’s edits have improved the article. The sections added under the “Medical Uses” section was an important addition, particularly the paragraph describing the dosing regimen and comparison between PrEP and ED-PrEP. This section definitely achieved the group’s goal to include information about how and when to use PrEP, and the language used was appropriate and easy to understand. They were also careful to not use medical language and did not refer to those taking PrEP as “patients,” which was appropriate. I appreciated the section “Availability and Pricing in the United States,” although I thought that the information added to this section aligned more with your goal for the “Politics and Culture” section, but you got the information into the article and it is definitely a valuable addition. I cannot see any evidence of plagiarism, and the group has included appropriate citations and references throughout the new additions to their article. Gmackey18 (talk) 21:03, 3 August 2020 (UTC)Gmackey18

This group has edited a top importance C level article. Through the suggestion of past editors, they have committed to editing significant portions related to populations, the medications themselves, other relevant conditions through prophylaxis, programs and new data. Sections that view as significantly edited: beginning information related to programs has been added, complications of medication, additional population information related to specific populations, particularly trans individuals, pregnancy, and the elderly- but also cultural implications of populations, and significant citations. Sections potentially needing work: intro is lacking citations, other relevant conditions using prophylaxis. This draft is written in a neutral point of view. No conflicts of language have been found. It is educational, informative, and not conflicting in presentation.Alansfeld (talk) 21:00, 3 August 2020 (UTC)ALandsfeld

Overall, I think edits to the page are very well done with each of your suggestions being addressed in some way. The edit to the introduction has made the beginning of the article more coherent and clear. Availability and pricing information was added in each addition of the edits made by the authors. Population edits were addressed when speaking on 2+1+1 dosing. How it is used and when it is used is addressed through guidelines. Politics and culture is addressed through talks about California’s senate bill. In terms of the edits aligning with the Wikipedia manual of style, references to primary literature is not preferred so the article does fall short in this way; however, again, I thoroughly enjoyed these edits and think it was well edited. --M.Ocampo, Future UCSF Pharm.D. (talk) 21:10, 3 August 2020 (UTC) — Preceding unsigned comment added by M.Ocampo, Future UCSF Pharm.D. (talk • contribs)

Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”? Yes. The title is short and simple and the sections are clear to non-experts. All claims are supported with citations and the formatting is consistent with the general structure of Wikipedia.

Has the group achieved its overall goals for improvement? The group has achieved its overall goals for improvements. Future editors may follow RJonesUCSF’s suggestions for sections on medical interventions.Ekocharyan (talk) 21:16, 3 August 2020 (UTC)

PrEP in Spain has already been publicly implemented in the healthcare system — Preceding unsigned comment added by 84.88.68.98 (talk) 15:20, 28 October 2020 (UTC)

Cabotegravir as PrEP

There have been a handful of studies into using injectable cabotegravir for long-acting pre-exposure prophylaxis; I can't do so right now, but it would be good to incorporate that into this article, as an update to the "Emerging treatments". Here's a couple of news articles on the topic

• Benjamin Ryan (July 7, 2020). "Injectable PrEP Is Even More Effective Than Daily Truvada". Poz.
• Benjamin Ryan (November 9, 2020). "For Women, Injectable Cabotegravir Is More Effective Than Truvada as PrEP". Poz.

— OwenBlacker (he/him; Talk; please {{ping}} me in replies) 14:40, 11 November 2020 (UTC)

Proposed split

As mentioned above several years ago, this article is in theory a generic concept about pre-exposure prophylaxis, as it can apply to many diseases and infections, such as malaria.

However the vast vast majority of its contents are actually talking only about a specific usage of PrEP – for HIV prevention. This is one of the most notable and discussed uses of PrEP, but it shouldn't take over the entire article. Since HIV PrEP is clearly notable in its own right, I propose the article be split into HIV pre-exposure prophylaxis (name is only a suggestion, not set in stone), and Pre-exposure prophylaxis.

The ideal way of doing this would be to do a reverse split, and move this article to HIV pre-exposure prophylaxis (because nearly all of its content is about this topic specifically) and spin the much smaller content about PrEP as a general medical practice out into a separate article with the current name. i.e.

• Pre-exposure prophylaxis is moved to HIV pre-exposure prophylaxis (or similar name)
• New article usurps the title Pre-exposure prophylaxis dealing with it as a general medical topic, the way we have articles on antibiotics, cauterization etc., which are not focused on their use for a specific illness or condition. - Estoy Aquí (talk) 14:08, 31 December 2022 (UTC)

• Support although the article is currently not that long, these are independently notable concepts that could be covered in enough detail to warrant their own individual articles. Tom (LT) (talk) 06:18, 13 May 2023 (UTC)

Support When people say PrEP, 9 times out of 10, they are referring to it in the context of HIV/AIDS. PrEP in other contexts deserves a separate article. 2013creek (talk) 19:26, 19 June 2023 (UTC)

• Support but titles should be "Pre-exposure prophylaxis" and "Pre-exposure prophylaxis (treatment)". I question the notability and use of this term outside the context of HIV, and would not want to qualify or deprecate the well-established use of the term to refer to HIV. Alternative uses should take the qualification. Bluerasberry (talk) 19:32, 19 June 2023 (UTC)
• Support name changes that Bluerasberry suggests: this is pretty much exclusively used in contexts relating to HIV/AIDS, so much so that it is the clear primary topic. – GnocchiFan (talk) 10:40, 13 July 2023 (UTC)
• Since support for some form of this seems to have been unanimous, I've now implemented a synthesis of the suggestions above. — The Anome (talk) 13:14, 30 November 2023 (UTC)

Wiki Education assignment: Wikipedia for the Medical Editor

This article was the subject of a Wiki Education Foundation-supported course assignment, between 29 January 2024 and 23 February 2024. Further details are available on the course page. Student editor(s): Stazlouken (article contribs). Peer reviewers: Nfaulk2.

— Assignment last updated by Nfaulk2 (talk) 02:49, 15 February 2024 (UTC)

Hello all, I am a student in a Wikipedia for the Medical Editor course and am updating this page for my class project. Here is my proposed plan for the article so far:

Introduction: Edit #1- I have made a few edits here to make the article more concise (re-worded a few sentences, removed repeated information, updated information and citations with most recent CDC guidelines).

Medical Uses: The medical uses are updates and I did not notice any changes needed to be made in the United States section.

Eligibility, Follow-Up Care, Dosage: Edit #2- I updated the eligibility for initiation of PrEP based on the 2021 guidelines. Edit #3- I made minimal changes to the 2^nd paragraph in this section to include “other protective barrier methods”. Edit #4- The 3^rd paragraph is now regarding the use of Oral PrEP. Edit #5- I included a paragraph on Injectable PrEP now that it is FDA approved and has some dosing/follow-up care that differs from oral PrEP.

Future Edits:

1. Event-Driven PrEP and PrEP during Pregnancy and Postpartum: Will plan to update these with most recent guidelines.
2. Contraindications: Plan to include Injectable PrEP contraindications
3. Side Effects: Plan to update current information already written in this section with secondary sources. Plan to include side effects for injectable PrEP.
4. Society and Culture: Plan to include more recent systematic reviews regarding PrEP, such as awareness/willingness to use, PrEP use among black and latina women, etc.

Stazlouken (talk) 22:21, 8 February 2024 (UTC)stazlouken