Van Epps P, et al. - Researchers performed a retrospective cohort study among persons initiating preexposure prophylaxis (PrEP) in the Veterans Health Administration (VHA) between July 2012 and April 2016 using national VHA data in order to elucidate the incidence of HIV and patterns of PrEP use within the VHA. Eight hundred twenty-five unique patients (mean age: 41 years) initiating PrEP were identified; of these, 97% were men and 67% were white. During the study period, they identified six HIV infections, yielding an HIV incidence of 0.8 (Poisson exact 95% confidence interval: 0.3 to 1.8) cases per 100 person-years. Findings thereby suggest the rare occurrence of HIV infection in a nationwide cohort of PrEP users. Although the infections mostly occurred during inconsistent PrEP use, infection occurrence was also reported during periods of high measured adherence. Findings thereby highlight the value of PrEP persistence during periods of risk.