Are we PREPared? Quality of information available to patients in the UK about PREP on the internet

Professional bodies in the UK (BASHH/BHIVA) do not currently recommended pre‐exposure prophylaxis (PREP) to prevent HIV aquisition for men who have sex with men (MSM) [1]. Conversely, although Federal Drug Administration approval is awaited, the Centers for Disease Control (CDC) have issued clinicians in the USA with interim guidance to facilitate PREP prescriptions [2]. Increasingly patients search the internet for information on HIV treatment, but disparate international policy can lead to confusing patient messages. This study was conducted to systematically assess the quality of internet information available to patients in the UK about PREP. More than 90% of internet searches in the UK are performed using ‘Google.co.uk’ and ‘Bing’ [3]. Using pre‐specified criteria, we reviewed the first 100 hits retrieved from each search engine when the following searches were performed: [“HIV pre‐exposure prophylaxis”]; [“HIV PREP”]; [“HIV PREP guidelines”]; [“HIV PREP guidelines UK”]; [“truvada prophylaxis HIV”]. Of 172 unique websites identified, 124 websites were active at the time of the review (July 2012). 33 websites were links to academic journals including commentaries and clinical trials, not intended to specifically provide patient information; 5 were internet portals directing users to alternative sites and 10 websites contained no information about PREP. Of the remaining 76 websites, 28 were written by medical professionals and 48 were written by journalists, where 7/48 (15%) were individual blogs. 64/76 (84%) contained a definition of PREP; 63/76 (83%) discussed the rationale and 58/76 (76%) reported efficacy data. Advantages and disadvantages of PREP were presented in 56/76 (74%) and 41/76 (54%) of websites respectively. Only 21/76 (28%) of sites referenced existing national guidelines (CDC/BASHH). A minority of sites described the current clinical practice in the UK (7/76, 9%) with an even smaller number presenting the contrast in clinical stance between the CDC and BASHH/BHIVA (3/76, 4%). The use of PREP is evolving, and the internet is an important patient resource. However, current clinical practice in the UK is seldom described in accessible websites. Avoiding ad hoc and unsupervised use of PREP is crucial to prevent future drug resistance and risky sexual behaviour. More should be done to engage at‐risk groups and ensure patients in the UK have access to comprehensive information including the current UK PREP professional guidance.