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Important news on PrEP

(aidsmap.com) In the last two weeks, two separate studies of Truvada as pre-exposure prohylaxis (PrEP) have found that it is highly effective in reducing the risk of HIV infection for HIV-negative gay men. Both studies have announced their results much earlier than planned, because the evidence of effectiveness came much sooner than had been anticipated.

These dramatic results give new impetus for PrEP to be made available to gay men in the UK and elsewhere in Europe. So far it has only been offered to men taking part in the research trials.

The PROUD study recruited around 500 men in England. Half were offered PrEP immediately and half were asked to wait one year. On Thursday October 16, its researchers announced that all men in the study will now be able to take PrEP.

The IPERGAY study involved around 400 men in France and Canada. Half were given PrEP and half were given a dummy pill (a placebo). Yesterday, its researchers also announced that all its participants will now be given a tablet that really does contain Truvada.

Men in the English study were asked to take a tablet every day. Those in the French study were told that they only needed to take it before and after sex – a dose in the 24 hours before anticipated sex, and then, if sex happened, two separate doses in each of the two days that followed.

In both studies, an analysis of the results – conducted ahead of schedule – found that the number of HIV infections in the group of men who had not been given PrEP was much higher than among those given PrEP. The differences were so clear and so large that it was felt that it would be unethical to continue to deny PrEP to the men in the comparison groups.

Nonetheless, precise figures will not be published until early next year. The researchers for both studies will also remain in contact with study participants in order to collect long-term data on several key issues – adherence, sexual behaviour and drug resistance.

Professor Jean-François Delfraissy, director of the French HIV research agency the ANRS commented: "This is a major breakthrough in the fight against HIV. The results of the ANRS IPERGAY trial should change national and international recommendations for HIV prevention".