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Since then, Centers for Disease Control and Prevention guidelines for the use of PrEP have been published and implemented into clinical practice throughout the United States. A number of published open\u2010label and PrEP demonstration projects have evaluated the real\u2010world use of PrEP including analysis of the barriers to its use and addressing major concerns. Despite the approval of FTC\/TDF for PrEP, its use for this indication relies on patient and provider acceptance, and its effectiveness requires patient adherence and retention in care during periods of high\u2010risk behaviors. Concerns regarding the use of PrEP in healthy individuals persist and include medication adverse effects including renal dysfunction and bone mineral density loss; risk compensation leading to HIV infections, sexually transmitted infections, and unintended pregnancies; and the development of drug resistance in the event of seroconversion. The cost\u2010effectiveness of PrEP continues to be assessed with the greatest cost\u2010effectiveness remaining in those at highest risk of acquiring HIV. Additionally, cases of HIV acquisition in individuals who are adherent to PrEP highlight scenarios in which PrEP is not 100% effective including against the transmission of drug\u2010resistant HIV strains. This review examines data on the implementation of PrEP outside the setting of clinical trials with the aim of providing clinicians with a summary of the current barriers and opportunities for PrEP use with a specific focus on the role of pharmacists in the optimization of PrEP implementation.<\/jats:p>","DOI":"10.1002\/phar.2240","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T22:32:33Z","timestamp":1551306753000},"page":"486-500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Review of Real\u2010World Implementation Data on Emtricitabine\u2010Tenofovir Disoproxil Fumarate as HIV Pre\u2010exposure Prophylaxis in the United States"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4872-9218","authenticated-orcid":false,"given":"Jessica L.","family":"Adams","sequence":"first","affiliation":[{"name":"Philadelphia College of Pharmacy University of the Sciences Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karishma","family":"Shelley","sequence":"additional","affiliation":[{"name":"Philadelphia College of Pharmacy University of the Sciences Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie R.","family":"Nicol","sequence":"additional","affiliation":[{"name":"University of Minnesota College of Pharmacy Minneapolis Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Center of Disease Control.Press Release: New HIV infections drop 18 percent in six years. 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