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 According to the U.S. Centers for Disease Control and Prevention,
eligible gay and bisexual men meet any of three criteria: they have
unprotected anal sex in a monogamous relationship with a partner not
recently tested for HIV, or they have unprotected anal sex with a
partner outside of a monogamous relationship or they have any anal
sex with someone who is HIV positive.
Getting the drug, known as Truvada and manufactured by Gilead, to 40
percent of high-risk men would prevent 1,162 infections among every
100,000 gay and bisexual men over 10 years, researchers estimate in
The Journal of Infectious Diseases.
The daily pill is a combination of two antiretroviral drugs that
work to keep the human immunodeficiency virus (HIV), which causes
AIDS, from reproducing in the body. Approved by the U.S. Food and
Drug Administration in 2012, Truvada is often just referred to as
PrEP, which stands for pre-exposure prophylaxis.
"We were all interested in estimating the public health impact and
efficiency of PrEP," said Samuel Jenness, the study's lead author
from Emory University in Atlanta.
Jenness and colleagues point out that PrEP is 92 percent effective
in preventing HIV infections.
To see how PrEP might change the number of new infections over the
next decade, the researchers used a mathematical model that took
into account HIV transmission rates among men who have sex with men
and the CDC guidelines.
They ran several scenarios through the model and found that getting
PrEP to 40 percent of eligible men - and having 62 percent stick to
the daily regimen - would avert 33 percent of expected infections
among all gay and bisexual men in the U.S. over the next decade,
compared to a scenario in which the drug was not available.
Getting PrEP to 10 percent of eligible men would avert about 11
percent of expected new infections, and increasing coverage all the
way to 90 percent would avert about half of cases, the researchers
calculated.
In a scenario where 40 percent of eligible men take PrEP, the
researchers say, having 25 men taking the pill every day would
prevent one new HIV infection.
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Counseling men on adhering to the daily pill would maximize the
public health investment by decreasing the number of men needed to
treat to prevent one infection, they add.
Jenness told Reuters Health that currently, 5 percent to 10 percent
of gay and bisexual men take PrEP.
In an editorial published with the study, an HIV expert said he's
not sure it's actually possible to get 40 percent of eligible gay
and bisexual men to take PrEP.
"However, PrEP studies from the United States, the United Kingdom,
Canada, France, and other high-income countries are showing that
those who seek out PrEP have substantial HIV risk and adhere well,
resulting in near elimination of HIV acquisition," writes Dr. Jared
Baeten, of the University of Washington in Seattle.
Those results show the men currently starting PrEP are good
candidates, he said.
SOURCE: http://bit.ly/29H7FNb The Journal of Infectious Diseases,
online July 14, 2016.
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