Ethics of PrEP and early initiation of art for prevention: How should countries reach a decision?
Recent trials demonstrate that the antiretroviral (ARV) drugs currently used to treat people living with HIV can also serve for prevention purposes. Two new HIV prevention strategies based on ARVs are now under consideration. The first consists of pre-exposure prophylaxis (PrEP), or the use of ARVs by high-risk HIV-uninfected people to avoid the acquisition of HIV infection. The second entails the early initiation of ARVs in individuals with HIV infection, at an earlier time than recommended for treatment purposes, in order to decrease transmission to uninfected sexual partners.
These uses of antiretroviral drugs for other than immediate lifesaving purposes have been called unethical by some critics. This meeting of ethicists and national programme planners considered these criticisms and addressed the question more from the perspective of public health ethics.