By Phill Wilson, President and CEO of the Black AIDS Institute
LOS ANGELES - The announcement of the results of a National Institutes of Health pre-exposure prophylaxis (PrEP) study is a major breakthrough in HIV prevention because it proves that HIV infection can be interrupted.
PrEP is one of the most promising prevention tools on the horizon. With PrEP, High risk HIV-negative individuals take antiretroviral medications daily to prevent becoming infected with the virus. The first round of PrEP studies tested tenofovir alone-also known as Viread-the anti-retroviral and one of the so-called HIV 'morning after pills' effective in post exposure prophylaxis (PEP). This study and later clinical trials are testing tenofovir and emtricitabine, the combination known as Truvada.
The study found a daily dose of Truvada reduced the risk of acquiring HIV infection by 43.8 percent among men who have sex with men (MSM). Even higher rates of effectiveness were reported-up to 73 percent-among participants who adhered most closely to the daily drug regimen. This tells us a number of things that will be key in HIV prevention in the Black community.
First, it tells us that we can stop or prevent HIV infection among people that could be exposed to the virus. That's important. Now, this study only tested PrEP's efficacy among MSM, so we have to wait for other studies that focus on women and heterosexual men. But Black MSM continue to be hard hit by HIV/AIDS-see our brand new report on the latest round of data from CDC, More Black Gay/Bi Men HIV Positive, Most Unaware.
Second, there were concerns that with the availability of PrEP, men would dramatically increase risky behavior. We didn't see that in this study. But we want to caution people from misinterpreting the results. Condom use and decreasing sexual partners remain the most effective way for gay and bisexual men to protect against HIV infection. PrEP should only be an additional tool in our prevention and protection portfolio.
And finally, the participants did not appear to develop resistance to the drug regimen.
"It's critically important to determine how this data holds up in the real world." Says Phill Wilson, President and CEO of the Black AIDS Institute. "We need to see the results of more trials and we need funding for demonstration projects. Also, how do we create environments where we can increase adherence to PrEP? And, during a global recession when many nations, including our own, are cutting back on HIV/AIDS funding, how do we advocate for PrEP funding but maintain our commitment to treatment, especially the expensive but life-saving antiretroviral regimens?"
"This is a very important study." Says Wilson. "But don't break open the champagne yet until we see what happens in the real world."