Pre-Exposure Prophylaxis (PrEP): A Major Advance in HIV Prevention Research
November 2010
The National Institutes of Health announced the results of the international iPrEx clinical trial, co-sponsored by the Bill and Melinda Gates Foundation, that examined whether a pill containing two drugs used to treat HIV can also help prevent HIV infection – an approach called pre-exposure prophylaxis, or PrEP. The trial found that daily oral use of tenofovir plus emtricitabine (brand named Truvada ®) provided an average of 44 percent (95% CI 15 to 63%) additional protection to trial participants that included gay, bisexual, and other men who have sex with men (MSM), as well as transgendered women who have sex with men. These participants also received a comprehensive package of prevention services that included monthly HIV testing, condom provision, counseling, and management of other sexually transmitted infections.
A key finding of this trial was that the level of protection individuals received from PrEP was dependent on how consistently participants used PrEP. Among those whose data (based on self-reports, bottles dispensed, and pill counts) indicates use on 90 percent or more days, HIV risk was reduced by roughly 73 percent (95% CI 41 to 88%); while among those whose adherence by the same measure was less than 90 percent, HIV risk was reduced by only 21 percent (95% CI, from 52% reduction to a 31% increase). Risk behavior among participants declined overall during the trial both in terms of decreases in the number of sexual partners and increases in condom use, likely as a result of the intensive risk reduction counseling provided as part of the trial.
To download and read the complete Dear Colleague Letter from the DHHS, please click here.
For additional information, please refer to the PrEP fact sheet on the CDC’s website by clicking here.
Additional information can be viewed on the NIAID’s website by clicking here. A Q&A can be viewed by clicking here.
The following are a series of brief podcast commentaries by Johns Hopkins HIV expert, Dr Joel Gallant:
Drugs work. A two-drug combination taken daily in men at risk to become infected with HIV largely prevented infection with the virus, a recent study in the New England Journal of Medicine showed. Joel Gallant, an HIV expert at Johns Hopkins, lauds the study.
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Who’s paying? How would efforts to prevent HIV infection with drugs be funded? Joel Gallant, an HIV expert at Johns Hopkins, comments.
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Not enough testing. Most Americans still don’t know their HIV status. Joel Gallant, an HIV expert at Johns Hopkins, says there’s a very compelling reason to test everyone. Listen Now
Transplant cure. A single patient cured of HIV by a bone marrow transplant isn’t a trend. But Joel Gallant, an HIV expert at Johns Hopkins, comments. Listen Now
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