Durban 2016. Scientific evidence shows benefits of PrEP in young population

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Source:Ā notiese.org

  • In sero-discordant couples the efficacy was over 90 percent
  • Consumption increases in the United States

Work Group on HIV Treatments – NotieSe

Jared Baeten

Durban, South Africa, July 22, 2016.

The use of pre-exposure prophylaxis is still a subject of study for multiple scientific teams all over the world in order to improve the schemes and think of better ways to promote its use, especially after the World Health Organization suggested offering it to ā€œpeople in significant risk of infection due to HIVā€, and that the United States approved its use in 2012, although only for adults.

Within the framework of the 21st. International Conference on AIDS, held from July 18 to 22,, in Durban, South Africa, Sybil Hosek from the Stroger Hospital of Chicago, presented a study made among gay young men and other young men that have sex with men minors (HSH), where the results showed that they can have a good level of adherence to pre-exposure prophylaxis (PrEP), but with the proper support provided.

In the research there were 79 HSH between 15 and 17 years, whose demographic characteristics and sexual behavior showed that these men were in a high risk situation for HIV infection.

Third of participants were black, a similar number of mixed (mestiza) race and 21 percent Hispanic. The participants had sexual experience, and declared they had a mean of two sexual partners in the last month. In addition, 60 percent had anal sex without condoms with their last partner; approximately one fifth had been paid for sex and 15 percent had a sexually transmitted infection (STI) at the beginning of the study.

The daily intake of Truvada as PrEP was safe and well tolerated. None of the participants stopped taking the prophylaxis due to secondary effects and all men maintained a good renal function.

Three participants were infected by HIV, equivalent to an incidence rate of 6.41 for 100 people-years, value ranked among the highest values registered in a PrEP program. This high infection rate may be explained by the fact that the participants did not take the tablets on regular basis (adherence problems).

At the beginning, volunteers received monthly support to the adherence, which resulted in high rates of medicine intake and some protective levels of drug were detected in the blood.

However, the adherence rate and levels of drug in the blood decreased significantly, once the participants received the support in a quarterly basis.

According to the researcher, this data will be presented to regulatory agencies of the drug in US territory to support a request for the use of PrEP in people under 18 years.

Sero-discordant couples

According to Jared Baeten, researcher of the Washington University in Seattle, PrEP may be useful in sero-discordant couples (where one person has HIV and the other does not), during the first six months after the beginning of antiretroviral therapy by the sero positive member.

At the presentation of final results of the Demonstration Project Partners PrEP, held in Kenya and Uganda, with the participation of one thousand 13 sero-discordant couples, where none of the people living with HIV was taking antiretroviral treatment at the beginning of the study, it was found that PrEP reduces the infection risk by more than 90 percent if it is taken correctly.

All sero-positive participants were offered antiretroviral therapy, whereas sero negative couples were offered PrEP while the partner would not begin the therapy and during the first 6 months of therapy.

At the end of the follow-up period, 4 new infections due to HIV were registered, a lower figure than the 83 that would be expected if antiretroviral therapy or PrEP would have not been used. The four infections originated among couples that were not taking antiretroviral therapy or pre-exposure prophylaxis.

Consumption increases

Figures presented by Gilead showed that in the United States more than 79 thousand people have taken PrEP in the last 4 years, especially in cities with large gay populations, so that, they said some other population groups are not receiving the real benefit that they could get.

According to the speakers, after the approval for use in July 2012, the use was slow until consumption increased by the end of 2013, due in part to the promotion made by members of gay and bisexual communities within their population groups.