POZ’s October/November Issue is Out Online … And it’s All About PrEP

Although PrEP was approved by the U.S. FDA in 2012, only recently has there been an uptick in buzz about this potential game-changing drug. In many ways, PrEP has reawakened some intense arguments about what’s right and wrong in the sex lives of gay men.

Written by POZ editor-at-large Benjamin Ryan, our PrEP cover story dives deep into the controversy. We also explore the effect of PrEP on gay men — in an effort to broaden the conversation about pre-exposure prophylaxis.

As the issue makes clear, PrEP isn’t a silver bullet. So what is it? We look at all the arguments and then attempt to answer this question: Can personal choice and public health find common ground?

Americans Adhere Well to PrEP in Global iPrEx Study

Let’s dig a little bit deeper into that iPrEX trial: Depending on the U.S. city, adherence to the HIV prevention drugs among Americans were actually between 72 and 90 percent —much higher than the study’s overall adherence rate of 55 percent.

This analysis suggests that, had some PrEP trials been conducted solely among Americans, not only would the average adherence rates likely have been higher, but the overall efficacy would have been as well, since efficacy is tied to adherence.

Such a finding challenges the thrust of a recent advertising campaign launched by the AIDS Healthcare Foundation that seeks to highlight the poor adherence and overall efficacy rates in the various major PrEP trials in order to discourage the public and the medical and public health communities from embracing Truvada as PrEP.

As increasing numbers of HIV-negative MSM in the United States seek out the antiretrovirals, AHF president Michael Weinstein has sought to characterize PrEP as a “public health disaster in the making.”

Targeting PrEP to High-Risk Gays Would Lower HIV—For a Huge PriceA mathematical model put together by top AIDS researchers estimates that prioritizing PrEP for all men who have sex with men, “high-risk homosexuals” and injection drug users in NYC would avert just 24% of new HIV infections, for a cost of $49.6 million per infection avoided.Note: The model assumes that only half of a given targeted population would actually agree to take Truvada for HIV prevention (thanks to current public opinion surrounding PrEP) and also assumes that, as in the clinical trials of PrEP, adherence to the drug will be relatively poor — around 44%.
The only way to improve those stats, and the per-infection costs, researchers say, would be if more at-risk men agreed to take the drug — and actually kept up with their daily doses.

Targeting PrEP to High-Risk Gays Would Lower HIV—For a Huge Price

A mathematical model put together by top AIDS researchers estimates that prioritizing PrEP for all men who have sex with men, “high-risk homosexuals” and injection drug users in NYC would avert just 24% of new HIV infections, for a cost of $49.6 million per infection avoided.

Note: The model assumes that only half of a given targeted population would actually agree to take Truvada for HIV prevention (thanks to current public opinion surrounding PrEP) and also assumes that, as in the clinical trials of PrEP, adherence to the drug will be relatively poor — around 44%.

The only way to improve those stats, and the per-infection costs, researchers say, would be if more at-risk men agreed to take the drug — and actually kept up with their daily doses.

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Let’s stop HIV in New York City

  • If you are HIV-negative, PEP and PrEP can help you stay that way.
  • If you are HIV-positive, PEP and PrEP can help protect your partners.

 

Daily PrEP

PrEP is a daily pill that can help keep you HIV-negative as long as you take it every day.

  • Ask your doctor if PrEP (Pre-exposure Prophylaxis) may be right for you.
  • Condoms give you additional protection against HIV, other sexually transmitted infections, and unintended pregnancy.

 

Emergency PEP

If you are HIV-negative and think you were exposed to HIV, immediately go to a clinic or emergency room and ask for PEP (Post-exposure  Prophylaxis).

  • PEP can stop HIV if started within 36 hours of exposure.
  • You continue taking PEP for 28 days.

Many insurance plans including Medicaid cover PEP and PrEP. Assistance may be available if you are uninsured. Visit NYC Health’s website to find out where to get PrEP or PEP in New York City.

A Tampon-Like HIV Prevention Method for Women?So this is really cool: New research shows that tiny water-soluble electrospun fibers can quickly dissolve and deliver an antiretroviral to the vagina. They act as pre-exposure prophylaxis for HIV and can act in as little as six minutes. Scientists say the cloth could also be used for various bacterial, fungal and other viral infections. 
Photo: Medical News Today

A Tampon-Like HIV Prevention Method for Women?

So this is really cool: New research shows that tiny water-soluble electrospun fibers can quickly dissolve and deliver an antiretroviral to the vagina. They act as pre-exposure prophylaxis for HIV and can act in as little as six minutes. Scientists say the cloth could also be used for various bacterial, fungal and other viral infections.

Photo: Medical News Today