A global human immunodeficiency virus (HIV) epidemic persists despite data to support multiple effective and safe tools that prevent HIV transmission and acquisition. Human immunodeficiency virus preexposure prophylaxis (PrEP) for HIV-uninfected at-risk populations using tenofovir disoproxil fumarate emtricitabine is highly effective, safe, and recently endorsed by the US Preventive Services Task Force (USPSTF) as a grade A recommendation. In this Special Communication, we summarize current guidelines and expert recommendations in a call for wider adoption of PrEP prescribing activities by frontline primary care clinicians. Key components include the ideal contexts in which PrEP may be prescribed, eligibility criteria, clinical considerations and pitfalls, laboratory monitoring, prescription practices, situations that may warrant expert consultation, and future directions. Given the broad scope, access, and point-of-entry status of primary clinicians in health systems, generalists will need to be at the center of any successful effort to leverage the power of, and destigmatize PrEP to end the HIV epidemic.

中文翻译：

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HIV 暴露前预防——初级保健临床医生在结束 HIV 流行中的作用

尽管有数据支持多种有效和安全的工具可以防止 HIV 传播和感染，但全球人类免疫缺陷病毒 (HIV) 的流行仍然存在。使用富马酸替诺福韦地索普西恩曲他滨对未感染 HIV 的高危人群进行人类免疫缺陷病毒暴露前预防 (PrEP) 是高效、安全的，最近被美国预防服务工作组 (USPSTF) 批准为 A 级建议。在此特别通讯中，我们总结了当前的指南和专家建议，以呼吁一线初级保健临床医生更广泛地采用 PrEP 处方活动。关键组成部分包括可以开出 PrEP 的理想环境、资格标准、临床考虑和陷阱、实验室监测、处方实践、可能需要专家咨询的情况和未来的方向。鉴于卫生系统中初级临床医生的广泛范围、可及性和进入点状态，通才将需要成为任何成功努力的中心，以利用 PrEP 的力量并消除 PrEP 的污名以结束 HIV 流行。