RNNarrative ReviewAANA journal2025

PrEP-ared for Surgery? A Comprehensive Narrative Review of Perioperative Recommendations for Anesthesia Providers.

Jennifer R Majumdar, Jake W Forrester, Kelly S Haviland and 3 others

PMID 41056146

WHAT IT FOUND

The review suggests continuing PrEP around surgery unless contraindicated.

Teams should plan for kidney, bone, blood pressure, injection timing, and stigma concerns.

Key findings

01The review found no evidence supporting discontinuation of PrEP during surgery and recommends continuing it unless specifically contraindicated.

02Tenofovir-containing PrEP can involve kidney toxicity and bone mineral density loss, so NSAIDs should be used cautiously when renal impairment is possible.

03Patients may not disclose PrEP use because of stigma, so clinicians should ask about it as a routine medication.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The paper is a narrative review, not a systematic review, and it says the literature directly addressing PrEP in surgery is limited. Many recommendations are expert opinion rather than tested perioperative outcomes. The supplied text does not show a formal quality assessment of the included studies.

Declared interests

The supplied metadata labels the article as NIH extramural research support. The text does not include an author conflict-of-interest declaration.

The easy way to misread this

Do not read this as proof that PrEP is safe in every surgical patient. The review found no evidence supporting discontinuation, but it also says the literature is limited and much of the guidance is expert opinion.

Read it on PubMed →