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Pre-exposure prophylaxis decreases HIV infection rates among MSM

Among three communities with high rates of HIV, dispensing pre-exposure prophylaxis to men who have sex with men and transgender women was linked to lower rates of HIV, according to recently published data.

“Despite low adherence seen in some placebo-controlled [pre-exposure prophylaxis (PrEP)] trials, we observed high adherence among [men who have sex with men (MSM)] taking PrEP in this open label demonstration project. The study drug was detected in nearly all participants who underwent testing, and more than three-quarters achieved levels associated with high levels of protection,” the researchers wrote. 

Researchers analyzed data from the 2012-2015 Demo Project to assess trends in PrEP adherence, sexual behaviors, and rates of STIs and HIV among MSM and transgender women (n = 557) in San Francisco, Miami and Washington, D.C. Clinics included in the project dispensed Truvada (tenofovir disoproxil fumate/emtricitabine, Gilead Sciences) free of charge for 48 weeks, and provided patients with HIV testing, client-centered counseling and clinical monitoring.

Results demonstrated that among the 294 participants who had tenofovir diphosphate levels measured, 80% to 85.6% had protective levels present. 

Lower rates of protective levels were associated with black participants and those living in Miami, according to the researchers. Participants with stable housing or those reporting having condom-less anal sex with at least two partners within the last 3 months were more likely to have protective levels of tenofovir diphosphate, according to the researchers.

Among all participants, rates of STIs remained high but stable over the 3-year period (90 per 100 person years). 

The researchers noted that increasing the impact of PrEP will require further interventions that combat disparities among different races and housing situations.

“These results provide support for expanding PrEP implementation in MSM in similar clinical settings and highlight the urgent need to increase PrEP awareness and engagement and to develop effective adherence support for highly affected [black] and transgender populations,” the researchers concluded. – by Casey Hower

Disclosures: Liu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.