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to Section One | to Arts & Entertainment
posted Friday, February 27, 2015 - Volume 43 Issue 09
PrEP is 'game changer'
Two European studies agree
Section One
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PrEP is 'game changer'
Two European studies agree

by Mike Andrew - SGN Staff Writer

Two new studies, one British, one French, agree that PrEP is a potential 'game changer' in the fight against HIV/AIDS.

The British study, released February 24 shows that Truvada can be 86% effective in preventing new HIV infections when taken daily.

The PROUD study, carried out at University College London (UCL) and Public Health England, was launched in 2012. It followed 545 men who have sex with men at 13 different sexual health clinics in the UK.

A total of 276 participants received PrEP immediately, while 269 began taking the drug after a period of 12 months, which allowed the researchers to compare the groups.

'During the study period there were 19 HIV infections in the group not taking PrEP. If we can stop people getting HIV by giving them PrEP, we have an ethical duty to do so,' Deborah Gold, chief executive of Britain's National AIDS Trust, told Gay Star News.

'Furthermore, over the course of their lifetime the treatment of those 19 men will cost the NHS nearly £7 million. So the financial argument is clear, as is the ethical one. PrEP needs to be available on the [National Health Service] as soon as possible for all those who need it.'

Some HIV activists - the AIDS Healthcare Foundation in the U.S., for example - have worried that promotion of PrEP would lead Gay men to abandon condoms, but preliminary data from the study shows that condom usage among participants remained about the same both before and during the trial.

'The study shows two important things,' Gold added. 'One, that PrEP is highly effective in preventing HIV and two, that gay men won't just throw away the condoms as soon as they start taking PrEP.'

'PrEP is, quite simply, a game-changer,' according to Dr. Michael Brady, Medical Director at Terrence Higgins Trust, an HIV prevention and treatment foundation.

'We know that most gay men use condoms most of the time, and that this has prevented tens of thousands of HIV infections since the epidemic began in the UK. However, we also know that condomless sex vastly increases the risk of HIV being transmitted. This research shows just how effective PrEP can be in preventing transmission of the virus in groups at greatest risk; offering another line of defense alongside condoms and regular testing.

'We urge the Government, [National Health Service] England and Local Authorities to make PrEP a key priority in the fight against HIV.'

Sheena McCormack, Professor of Clinical Epidemiology at UCL, and Chief Investigator of the PROUD study, called the results 'extremely exciting.'

'Concerns that PrEP would not work so well in the real world were unfounded,' she said. 'These results show there is a need for PrEP, and offer hope of reversing the epidemic among men who have sex with men in this country.'

French study: 'On demand' PrEP equally effective
A French study, released at the same time as the UCL research, shows that PrEP is equally effective when taken 'on demand' - in other words, just before and just after having unprotected sex.

In this study too, Truvada was shown to be 86% effective in preventing HIV infections.

The study was conducted by the French national HIV research agency and involved men who have sex with men in both France and Quebec.

Researchers gave their subjects either Truvada or a placebo, and told them to take two pills from two to 24 hours before sex, a third pill 24 hours later, and a fourth pill 48 hours after the first dose. The men also were given condoms and disease prevention counseling.

Subjects who took the Truvada were 86% less likely to become infected with HIV than the control group.

While this method of PrEP use is commonly called 'on demand' it does require some planning to be effective. For example, it requires an individual to foresee having sex within the next 24 hours, and it requires the individual to adhere to the post-sex dosage sequence.

The CDC (Centers for Disease Control and Prevention) in the United States expressed reservations about the French study.

'Since available data suggest that men in this study were taking PrEP an average of three to four days per week, CDC cautions that researchers do not yet know if this regimen will work among MSM who have sex less frequently and would therefore be taking PrEP less often,' the agency said.

'It is not known whether the regimen will work if taken only a few hours or days before sex, without any buildup of the drug from prior use. Studies suggest that it may take days, depending on the type of sexual exposure, for the active drug in PrEP to build up to an optimal level for preventing HIV infection.'

The CDC also warned that the study did not survey how PrEP would work on straight men, women, or IV drug users.

'CDC continues to recommend only daily use of PrEP, as approved by the FDA,' the agency concluded.

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Two European studies agree

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