The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

Purpose of review Recent HIV outbreaks among people who use drugs (PWUD) necessitate additional HIV prevention tools. Pre-exposure prophylaxis (PrEP) is highly efficacious yet uptake among PWUD remains exceedingly low. To address multilevel, complex barriers to PrEP use among PWUD, a range of intervention strategies are needed. Recent findings The literature on interventions to optimize PrEP use among PWUD is nascent, comprising small pilots and demonstration projects in early phases of intervention development. Initial studies suggest that structural, healthcare, interpersonal, and individual-level interventions can improve PrEP use for PWUD, and a number of efficacy trials are underway. Future studies are needed to optimize the use of new PrEP modalities (e.g., injectable PrEP), simultaneously target multilevel challenges to PrEP use, and evaluate the integration of PrEP into other service settings and substance use treatment modalities.

Automated summary

The literature on interventions to optimize PrEP use among people who use drugs is still in its early stages, comprising small pilots and demonstration projects. Initial studies suggest that interventions at structural, healthcare, interpersonal, and individual levels can improve PrEP use for this population, with ongoing efficacy trials. Future studies are needed to optimize the use of new PrEP modalities, address multilevel challenges, and evaluate the integration of PrEP into other service settings and substance use treatment modalities.