What is the current guidance on the use of PrEP for patients at high risk of HIV exposure?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Current guidance on the use of pre-exposure prophylaxis (PrEP) for patients at high risk of HIV exposure:

  • PrEP should be offered to people at higher risk of HIV infection, using the criteria outlined in the British HIV Association (BHIVA) and British Association for Sexual Health and HIV (BASHH) guidelines .
  • PrEP involves taking antiretroviral tablets daily (daily PrEP) or, in some cases, event-based or on-demand dosing .
  • Specialist input is required at initiation and for ongoing monitoring of PrEP, including regular HIV testing and screening for sexually transmitted infections every 3 months ,,.
  • Primary care is not expected to prescribe PrEP but should support the broader HIV prevention strategy by offering HIV testing, condom provision, adherence encouragement, and discussing PrEP availability ,.
  • People taking PrEP should receive tailored information on effectiveness, adherence, side effects, and monitoring risks, and be supported to maximise adherence .
  • Kidney function and other potential adverse health events should be monitored during PrEP use .
  • Services offering PrEP should be accessible and welcoming to all eligible groups, with clear referral pathways from services that do not provide PrEP .
  • Awareness of PrEP should be raised among healthcare professionals and local communities, especially in groups with lower uptake or awareness, such as trans people, cisgender women, young people, and people from Black African or Caribbean backgrounds .

Educational content only. Always verify information and use clinical judgement.