Featured news from NHIVNA
HIV-related news from NAM
Evidence for PrEP efficacy grows, but implementation presents challenges
Liz Highleyman, 2015-12-18 09:40:00
prophylaxis (PrEP) was a major topic at the 2015 National HIV Prevention Conference (NHPC) last week in Atlanta.
A growing body of evidence continues to confirm that Truvada PrEP is highly effective at preventing HIV infection if
taken regularly, both in clinical trials and in real-world clinical use. Yet
uptake has been uneven, and researchers and front-line health workers are
learning about barriers to PrEP implementation and scale-up for diverse population
"The argument is over about PrEP," US National
Institute of Allergy and Infectious Diseases (NIAID) director Anthony Fauci
said during his opening lecture. "If you take the drug, it works, not only
in a clinical trial but in the field."
That message appears to finally be getting out to
people at risk for HIV and their providers.
"We're now reaching a tipping point where
clinicians are hearing that their colleagues are prescribing PrEP and maybe
they could too," said Dawn Smith of the US Centers for Disease Control and
A plenary lecture by NIAID Division of AIDS director Carl Dieffenbach and dozens of abstract presentations were devoted to different aspects
of PrEP, ranging from knowledge and attitudes of users and providers, to
implementation of PrEP in various settings
"PrEP works, but only
if you take it," Dieffenbach emphasised, underlining the importance of
offering PrEP as part of a comprehensive prevention package that is attractive
to the people most at risk for HIV.
New PrEP methods are
"not on the horizon, but just over the horizon," Dieffenbach
continued, potentially including broadly
neutralising antibodies, microbicides in rings or other sustained-release
delivery systems and long acting injectable agents. "We may one day have PrEP that can be administered once a
year," he predicted.
Some of the most promising
findings on Truvada
(tenofovir/emtricitabine) PrEP in real-world use have come from cities with
large populations of gay men, progressive political attitudes and generous
public health funding.
But as New York City assistant health commissioner Demetre Daskalakis stressed, PrEP is "not just a big old gay good
time," and access needs to expand "beyond our gay choir."