BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP) 2018


We aim to provide evidence-based guidance on best clinical practice in the provision, monitoring and support of pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition. The guidelines include:

(i) Guidance on risk assessment prior to PrEP;

(ii) Baseline assessment;

(iii) Dosing schedules;

(iv) Monitoring;

(v) Supporting adherence;

(vi) Buying generic PrEP; and

(vii) Cost-effectiveness.

The guidelines are aimed at clinical professionals directly involved in, and responsible for, HIV prevention, and at community advocates and organisations responsible for supporting HIV prevention strategies in those at risk of HIV acquisition.

A detailed review of the evidence base is included in Section 4. Sections 5 to 7 are intended to offer practical guidance in risk assessment, starting PrEP, ongoing management while on PrEP and stopping PrEP.


BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP)NHS Evidence accredited provider

BHIVA BASHH PrEP guidelines

Additional information

BHIVA/BASHH PrEP guidelines proforma

PICO questions and search strategies

Consultation comments

The comments with replies from the Writing group can be downloaded here:

Download the comments received by the BHIVA Secretariat during the web consultation process

Download the comments received from the BHIVA Executive Committee and Guidelines Subcommittee following revision after the web consultation

Non-technical information on PrEP

Please see below for links to other organisations with non-technical information about PrEP:

(NB These are links to external sites for which BHIVA has no responsibility)

Writing group members


Michael Brady Consultant in Sexual Health and HIV, King’s College Hospital, London
Alison Rodger Reader and Honorary Consultant Infectious Diseases and HIV, University College London


David Asboe Consultant HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London
Valentina Cambiano Lecturer in Infectious Disease Modelling and Biostatistics, University College London
Dan Clutterbuck Consultant HIV and Sexual Health, NHS Lothian
Monica Desai Consultant Epidemiologist, Public Health England
Nigel Field Senior Lecturer, Consultant Clinical Epidemiologist, University College London
Justin Harbottle Programme Officer, Terrence Higgins Trust, London
Zahra Jamal Policy and Research Officer, NAZ, London
Sheena McCormack Professor of Clinical Epidemiology, MRC Clinical Trials Unit at University College London
Adrian Palfreeman Consultant HIV and Sexual Health, University Hospitals of Leicester NHS Trust
Mags Portman † Consultant HIV and Sexual Health, Mortimer Market Centre, London
Killian Quinn Consultant HIV and Sexual Health, King’s College Hospital, London
Melinda Tenant-Flowers Retired Consultant in HIV and Sexual Health Medicine, King’s College Hospital, London
Ed Wilkins Consultant in Infectious Diseases, North Manchester General Hospital
Ingrid Young Chancellor's Fellow, Usher Institute, University of Edinburgh

A full list of conflict of interest statements is available on request from BHIVA.

Guidelines updates and date of next review

The guidelines will be fully updated and revised in 2023. However, in the interim, new information from high-quality studies will be considered and where this is thought to be clinically important to ensure continued best clinical practice, the guidelines will be revised.