![]() ![]() Guidelines recommend STI testing before starting and, periodically on PrEP ( 1) given the increased risk for STI acquisition. Indications include being HIV-negative and reporting anal or vaginal sex plus any of ( 1) HIV-positive partners with unknown or detectable viral load, ( 2) a bacterial sexually transmitted infection (STI), and ( 3) inconsistent condom use or injecting drugs, and sharing injecting equipment or injecting with HIV-positive partners ( 1). HIV pre-exposure prophylaxis (PrEP) reduces the likelihood of HIV acquisition and is recommended for high-risk groups. PrEP delivery programmes should consider prioritizing the long-acting injectable INSTI, cabotegravir, in HTLV-1 endemic settings. Further data are required to evaluate antiretroviral efficacy in preventing HTLV-1 transmission from in vitro studies, animal models, and clinical cohorts. We suggest that systematic seroprevalence studies among PrEP-using groups, including men who have sex with men (MSM), people who inject drugs (PWIDs), and female sex workers (FSWs), are needed. ![]() In this scoping review, we, therefore, (1) discuss the epidemiological context of HIV-PrEP and HTLV-1 transmission (2) present current knowledge of antiretrovirals in relation to HTLV-1 transmission prevention, including nucleos(t)ide reverse transcriptase inhibitors (NRTIs) and integrase strand transfer inhibitors (INSTIs) and (3) identify knowledge gaps where data are urgently required to inform global public health measures to protect HIV-PrEP users from HTLV-1 acquisition. The 2021 WHO Technical Report on HTLV-1 called for the strengthening of global public health measures against its spread. HTLV-1 is not mentioned however, it is predominantly sexually transmitted, causes adult T-cell leukaemia/lymphoma (ATL) or myelopathy in 10% of those infected, and is associated with an increased risk of death in those without any classically HTLV-associated condition. Diagnosed infections can be promptly treated to reduce onward transmission. Guidelines recommend testing for sexually transmitted infections (STIs) before starting, and periodically on PrEP, including bacterial infections, HIV, hepatitis C virus, and, for those who are non-immune, hepatitis B virus. HIV pre-exposure prophylaxis (HIV-PrEP) is effective in reducing the likelihood of HIV acquisition in HIV-negative people at high risk of exposure. 3Imperial College London, London, United Kingdom.2National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom.1Virus Reference Department, UK Health Security Agency, London, United Kingdom.Health Literacy Online: A Guide for Simplifying the User Experience.Daniel Bradshaw 1,2 * and Graham Philip Taylor 2,3 Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Washington, DC: The National Academies Press. National Academies of Sciences, Engineering, and Medicine. Improving newborn screening laboratory test ordering and result reporting using health information exchange. ![]()
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