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Public health significance of human immunodeficiency virus pre-exposure and post-exposure prophylaxis.

To eliminate the public health threat of the global human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) epidemic by 2030, the Joint United Nations Programme on HIV/AIDS launched 90-90-90 control targets in 2014 to help end the spread of HIV. China has responded actively by scaling up and expanding HIV testing and implementing early antiretroviral therapy (ART). In progressing towards achieving the 90-90-90 targets, China, in 2018, achieved higher percentages on the second (83.4% vs. 79.5%) and third (94.2% vs. 79.9%) “90” targets than the average global levels but a lower percentage on the first “90” target (69.3% vs. 79.9%), the aim of which is to have 90% of all people living with HIV (PLWHIV) knowing their HIV status. At the same time, the estimated number of PLWHIV in China increased from 0.81 million in 2013 to 1.25 million in 2018. In addition, while AIDS ranked third for the number of cases of nationally notifiable legal infectious diseases in 2019, it ranked first for the number of deaths resulting from such diseases. The above evidence indicates that overreliance on HIV testing and early ART is far from sufficient to control HIV completely. It is necessary to move forward with direct prevention and control strategies that reduce the risk of HIV infection in key populations. HIV pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP) are just two of the measures that need to be fully utilized in this effort.