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Oral tenofovir-based PrEP works. Faster, smarter rollout must be a top priority.

Recent clinical trials have shown clearly that daily, oral pre-exposure prophylaxis (PrEP) using the antiretroviral drugs tenofovir and emtricitabine dramatically reduces the risk of HIV infection for men and women who take it as directed. While PrEP won’t be right for every individual at risk for HIV, untold numbers of men and women will benefit – if they can access this potentially life-saving option.

So far, PrEP’s implementation has been piecemeal and incomplete. The pace and demand are picking up in the United States. In other countries, including some where the research took place, there is limited or no access. For maximum impact, PrEP rollout needs a coherent, global strategy involving many real-world demonstration projects, other research, and guidance from global health agencies. At the same time, research into new PrEP formulations—such as intermittent use of pills, or quarterly injections—could help improve adherence and achieve PrEP’s full potential.

What We're Reading

A new report summarizes the discussion and recommendations generated at a July 2015 consultation on clinical, ethical and operational issues associated with oral PrEP in older adolescents. UNICEF convened this multi-stakeholder meeting with All In, a UN initiative to end adolescent AIDS.

September 21, 2015

Kenneth Mayer and Chris Beyrer, two leading HIV prevention researcher-advocates who have helped shape the agenda for PrEP and gay men and other MSM, argue the PROUD study shows that this PrEP strategy could readily be implemented outside the controlled environment of a clinical trial, and that in the “real world” it will be sufficiently effective to warrant wider use.

September 9, 2015

As reported in the New York Times, published results show that San Francisco’s largest private health insurer, Kaiser Permanente, found no new HIV infections among its 657 clients who received PrEP over a period of more than two years. The study showed a modest decrease in condom use among PrEP users but no increase in new cases of HIV. This is key observational data to help understand how PrEP use will affect HIV as use expands. The study did note an increase in other STIs, and an open-access commentary published alongside the paper emphasizes the importance of STI testing, treatment and prevention as part of PrEP programming.

September 2, 2015
NY Times
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