More prevention latitude.

In late January, the federal government approved the use of antiretroviral drugs to prevent HIV infection in people who have been exposed to the virus in nonoccupational settings. (1) Prophylactic use of such drugs has been recommended since 1996 for health care workers exposed to HIV on the job; however, until a recent, extensive review of the literature, the government was not persuaded that the benefits outweigh the risks for individuals exposed through situations such as sexual assault, a nonoccupational needlestick or an occasional failure to practice safer sex. Guidelines available on the Web site of the Centers for Disease Control and Prevention (CDC) provide an algorithm for clinicians to use to determine if an individual's risk is sufficient to warrant treatment; they also suggest specific drugs to prescribe for a 28-day regimen beginning within 72 hours after exposure. The CDC emphasizes that prophylactic antiretroviral treatment should be reserved for individuals who have been exposed to substantial risk and is "not meant to be a substitute for primary prevention practices."

(1.) Voelker R, Preventive antiretroviral use expands: approved for HIV exposure outside of work settings, Journal of the American Medical Association, 2005, 293(10):1177-1178.

Dore Hollander, executive editor of Perspectives on Sexual and Reproductive Health.