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We Need to be Better PrEPared
By now, many of you may have seen the headlines or read news about what sounds like encouraging results, announced in late October, about two clinical trials of PrEP (pre-exposure prophylaxis) in gay and bisexual men.
It’s important, however, to not make assumptions based on the preliminary findings about the PROUD and IPERGAY studies.
Before the scheduled end of the trials, the safety monitoring boards determined Truvada was effective in reducing the HIV infection rate among study participants, so they stopped the trials early and offered Truvada to all study participants.
The IPERGAY trial was especially interesting because it was testing different dosing strategies for Truvada, other than once a day. It’s important to know, however, that we don’t yet have the critical information we need to make firm conclusions about the frequency, timing or exact dose of PrEP required for protection.
Although there will be a full reporting of the data in scientific meetings and publications, it will take some time for that data to be fully analyzed. And because the trials were halted early, it’s possible there will not be enough data to answer all of the questions initially posed by the investigators.
We also don’t yet have important data regarding the risk behaviors of study participants, rates of HIV infection and adherence to the PrEP regimen.
So as we wait for more information from these and other important studies still underway, including the Center’s own study, I agree with the statement recently issued by the CDC. They “recommend the FDA-approved and proven regimen of daily oral Truvada for HIV prevention among those at substantial risk for HIV infection. Consistent daily use of PrEP (measured by a detectable level of medicine in the blood) has been shown to reduce the risk of HIV infection among MSM by as much as 92%.”
The Los Angeles LGBT Center believes PrEP is a very important component of a comprehensive strategy to reduce the number of people infected by HIV. Learn more about our position here.
Robert Bolan, M.D., is the Los Angeles LGBT Center’s medical director. A former president and chairman of the San Francisco AIDS Foundation, Dr. Bolan has been caring for people with HIV since the earliest days of the epidemic and is one of the nation’s foremost experts on HIV treatment.
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