Table 3.

Summary of published national and international guidelines for PrEP¹

	Indication for PrEP	MSM	Heterosexual men and women	People who inject drugs
CDC (2014)	Detection of substantial risk of acquiring HIV infection	RECOMMEND Any one of: HIV positive sexual partner Recent bacterial STIa High number of sex partners History of inconsistent or no condom use Commercial sex work (Note does not mention trans-populations)	RECOMMEND Any one of: HIV positive sexual partner Recent bacterial STI High number of sex partners History of inconsistent or no condom use Commercial sex work In a high-prevalence area or network	RECOMMEND Any one of: HIV-positive injecting partner Sharing injection equipment Recent drug treatment (but currently injecting)
WHO (2015)	Offer for people at substantial risk of HIV infection (provisionally defined as >3 per 100py)	HIV incidence >3 per 100 py Includes transgender women	HIV incidence >3 per 100 person years Includes heterosexual men and women with sexual partners with undiagnosed or untreated HIV where HIV incidence >3 per 100 person years	No recommendation made
EACS (2015)	Use in adults at high risk of acquiring HIV infection	RECOMMEND Inconsistent in use of condoms with casual partners or with HIV-positive partners who are not on treatment. Recent STI or use of PEPb may be markers of increased risk for HIV acquisition (includes transgender individuals)	CONSIDER Inconsistent in use of condoms and likely to have HIV –positive partners who are not on treatment	No recommendation made
ANRS (2015) In French*	Use in adults (aged >18) at high risk of HIV	RECOMMEND For sexually active MSM at high risk of acquiring HIV : Reporting condomless sex with at least 2 partners over a 6 month period Having had multiple episodes of STIs (syphilis, chlamydia, gonococcal infection, primary hepatitis B infection or hepatitis C infection) in the past year Multiple courses of PEP over the past year Use of psychoactive substances during sex in the past year Partners of HIV positive people who are taking part in trials of stopping ARVs NOT RECOMMENDED FOR: Condomless sex that is not associated with high risk of transmission of HIV	CONSIDER ON A CASE BY CASE BASIS Other people at high risk of acquiring HIV infection: Commercial sex worker having condomless sex Vulnerable individuals having condomless sex at high risk of transmission of HIV (partner from a group with high HIV prevalence-multiple sexual partners, from a high prevalence country (>1%), people who inject drugs, physical factors increasing transmission e.g. genital or anal ulcer, bleeding) Partners of HIV positive people who are taking part in trials of stopping ARVs NOT RECOMMENDED FOR: condomless sex that is not associated with high risk of transmission of HIV Sex with HIV positive partner who is well controlled on antiretroviral therapys (VL<50) PrEP for conception for serodifferent couples	Injecting drug users sharing needles
British Columbia (2016)	Ongoing high risk of acquiring HIV infection	One or more of: One or more HIV positive sexual partner, particularly if HIV positive partner is not receiving stable antiretroviral therapy and/or does not have a consistently undetectable viral load Recent (within last 6 months)STI Multiple sex partners History of inconsistent or no condom use for anal intercourse Repeated courses of PEP	One or more of: HIV positive sexual partner(s), particularly if HIV positive partner is not receiving stable antiretroviral therapy and/or does not have a consistently undetectable viral load Having sexual partners who are MSM or use injection drugs	Sharing injection equipment Injecting once or more times per day in an unsafe setting (outside of safe injection sites) Injecting cocaine or methamphetamine Repeated courses of nPEP
Quebec (2013) In French	For those at very high risk of acquiring HIV	Condomless anal sex with HIV positive or unknown status partners	HIV positive sexual partners with a detectable viral load	Not recommended
South Africa (2016)	At significant risk of acquiring HIV	Any sexually active HIV-negative MSM or transgender person who wants PrEP Especially: HIV positive sexual partner who is not confirmed virologically supressed Partner of unknown HIV status Recent STI Multiple sexual partners History of inconsistent or no condom use Commercial sex work Recurrent PrEP users History of sex whilst under the influence of alcohol or recreational drugs Especially vulnerable are young MSM	Heterosexual men and women who want PrEP, especially: HIV positive sexual partner who is not confirmed virologically supressed Partner of unknown HIV status Recent STI Multiple sexual partners History of inconsistent or no condom use Commercial sex work Serodiscordant couples trying to conceive Recurrent PrEP users History of sex whilst under the influence of alcohol or recreational drugs Especially vulnerable are adolescent girls	One or more of: HIV positive / unknown status injecting partner Share injecting needles and drug preparation equipment

¹Only guidelines published in English and French have been included

^aSTI: sexually transmitted infection

PEP: post-exposure prophlyaxis