Early Experiences Implementing Pre-exposure Prophylaxis (PrEP) for HIV Prevention in San Francisco

PointsN Pre-exposure prophylaxis (PrEP) has been demonstrated to be safe and efficacious in clinical trials and emtricitabine/tenofovir was approved by the United States Food and Drug Administration for use as PrEP in 2012.N We report early experiences with PrEP uptake and delivery in three different settings in San Francisco: a PrEP demonstration project in a municipal sexually transmitted diseases (STD) clinic, and two PrEP delivery programs (a private health maintenance organization and an HIV-specific reproductive health program).N Interest in PrEP is high in San Francisco, particularly among men who have sex with men attending the STD clinic, and it is feasible to incorporate PrEP into busy clinical settings.Key next steps for PrEP implementation include increasing PrEP knowledge; expanding PrEP access; combating PrEP stigma; and optimizing interventions to promote PrEP uptake and adherence while reinforcing risk reduction strategies.N PrEP can be an important component of a comprehensive HIV prevention program and complement efforts to increase HIV testing, linkage to care, and early initiation of antiretroviral therapy.