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In contrast, TDF/FTC was ineffective in preventing HIV acquisition among African women in both the Fem-PrEP and VOICE trials, findings likely driven by poor adherence among study participants. Recent data suggests that daily oral TDF is also effective in preventing HIV acquisition among injection drug users. , Efficacy in TDF2 rose to 78% when followup data was censored 30 days after the last reported dose of PrEP to reflect adherence. TDF/FTC was associated with a 75% reduction in HIV acquisition among serodiscordant heterosexual couples in a large Sub-Saharan African population (Partners PrEP), and a 62.6% reduction was seen in heterosexual transmission in Botswana (TDF2).

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The iPrEx trial, a randomized placebo-controlled trial of 2499 HIV-negative men who have sex with men (MSM) and transgender women, found daily oral tenofovir and emtricitabine (TDF/FTC) 44% effective in reducing incident HIV infection, with efficacy rising to 73% among those reporting >90% adherence. Recent studies demonstrate the efficacy of pre-exposure prophylaxis (PrEP), or the use of antiretroviral medications by HIV-negative persons to prevent HIV acquisition in high-risk settings. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Д¬ompeting interests: The authors have declared that no competing interests exist.Д¬urbing the incidence of new HIV infections is an important public health goal in Canada and globally. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ДЇunding: DHST is supported by a Randomized Controlled Trials Mentoring Grant from the Canadian Institutes of Health Research. Received: JanuAccepted: JPublished: August 18, 2014Д¬opyright: В© 2014 Sharma et al. PLoS ONE 9(8):Д®ditor: Nitika Pant Pai, McGill University Health Centre, McGill University, Canada Further research on real-world effectiveness, continuing medical education, and clinical support is needed to prepare physicians for this prevention strategy.Д¬itation: Sharma M, Wilton J, Senn H, Fowler S, Tan DHS (2014) Preparing for PrEP: Perceptions and Readiness of Canadian Physicians for the Implementation of HIV Pre-Exposure Prophylaxis. In summary, Canadian physicians demonstrate varying levels of support for PrEP and express concerns about its implementation. 75.3% did not feel that information had been adequately disseminated among physicians. Participants cited cost and efficacy as major concerns. The latter two were the strongest predictors on multivariate analysis. Self-identifying as an HIV expert (odds ratio, ORвЂЉ=вЂЉ4.1, 95% confidence interval, CIвЂЉ=вЂЉ1.6вЂ“10.2), familiarity with PrEP (ORвЂЉ=вЂЉ5.0, 95%CIвЂЉ=вЂЉ1.3вЂ“19.0) and having been asked by patients about PrEP (ORвЂЉ=вЂЉ4.0, 95%CIвЂЉ=вЂЉ1.5вЂ“10.5) were positively associated with willingness to prescribe PrEP on univariable analysis.

45.9% of participants felt вЂњvery familiarвЂќ with PrEP, 49.4% felt that PrEP should be approved by Health Canada, and 45.4% of respondents were willing to prescribe PrEP. Criteria for analysis were met by 86 surveys. We disseminated an online survey to Canadian family, infectious disease, internal medicine, and public health physicians between September 2012вЂ“June 2013 to determine willingness to prescribe PrEP. Little is known about Canadian physicians' knowledge of and willingness to prescribe PrEP. Recent evidence has demonstrated the efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, but concerns persist around its use.