Project 460666

New HIV infections continue to occur in Canada despite the existence of safe and efficacious prevention strategies such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). A shared, up-to-date knowledge base on how best to use these tools is critical to their effective rollout. Our team developed evidence-based Canadian guidelines on PrEP and PEP in 2017, using the rigorous GRADE system. The guidelines were endorsed by multiple professional societies, and have been important in raising awareness about PrEP and PEP, standardizing clinical practice, and informing policy nationwide. Our pre-specified timeline for updating the guideline was either when a new PrEP or PEP regimen obtained Health Canada approval, or within five years, and both these criteria have now been met. In particular, it is important to provide evidence-based recommendations to the Canadian healthcare community on novel PrEP formulations such as tenofovir alafenamide/emtricitabine and injectable cabotegravir. Our objectives are thus: 1.To assemble an interdisciplinary guideline panel of experts from across Canada with expertise in HIV pre- and post-exposure prophylaxis who will develop updated Guidelines; 2.To update systematic reviews of the literature on HIV pre- and post-exposure prophylaxis that will guide the expert panel in its deliberations; and 3.To convene a series of online meetings of the expert panel to develop the updated guidelines. We will follow the GRADE process by first articulating key questions and relevant clinical outcomes to be considered. We will engage two trainees in updating the systematic reviews and preparing evidence summaries for the panel, who will develop the updated recommendations in a series of working group and large team meetings in late 2022. Community members will actively contribute at multiple stages, including: identification of relevant clinical outcomes, panel deliberations, and critical review of the pre-final documents.