Daily PrEP reduces risk of HIV infection by 86%, UK study finds

Taking antiretroviral HIV medication daily can reduce the risk of HIV infection by up to 86%, a UK study has found.

The PROUD study – which has been examining the protection offered by pre-exposure prophylaxis (PrEP) to HIV negative men who have sex with men (MSM) – found that taking the drug Truvada daily proved “highly effective” in reducing the spread of HIV in a real-world setting.

Truvada is an antiretroviral drug which is already used to treat some people with HIV. The results of the PROUD study come after statistics published last year showed that the number of new HIV diagnoses among gay men hit a record high in 2013.

Of the 545 participants who joined the study, 276 received PrEP immediately and 269 were planned to receive PrEP after a deferred period of 12 months. Over the course of the first year, the group that weren’t taking PrEP saw 19 men contract HIV, compared to just three in the group that were taking PrEP.

The study indicated that one case of HIV could be stopped for every 13 men treated for a year. Due to the promising early results the trial was altered so that all participants are now getting the drugs.

While some critics have said PrEP could lead to a fall condom-usage, the study found that rates of other STIs such as Hepatitis C and Chlamydia remained the same in both groups. The findings also showed PrEP is well tolerated with minimal concerns about drug resistance.

Sheena McCormack, Professor of Clinical Epidemiology at the MRC Clinical Trials Unit at UCL and Chief Investigator of the PROUD study, said: “These results are extremely exciting and show PrEP is highly effective at preventing HIV infection in the real world.

“Concerns that PrEP would not work so well in the real world were unfounded. These results show there is a need for PrEP, and offer hope of reversing the epidemic among men who have sex with men in this country.

“The findings we’ve presented today are going to be invaluable in informing discussions about making PrEP available through the NHS.”

The cost of Truvada, made by Gilead, is around £360 a person a month. There are an estimated 10,000 to 15,000 MSMs in the high-risk category in the UK, including those who have multiple partners and sometimes do not use condoms.

Responding to the study’s findings, the chief executive of NAT (National AIDS Trust), Deborah Gold, said: “The study shows two important things – one, that PrEP is highly effective in preventing HIV and two, that gay men won’t just throw away the condoms as soon as they start taking PrEP (STIs were the same in men taking and not taking PrEP).

“During the study period there were 19 HIV infections in the group not taking PrEP. If we can stop people getting HIV by giving them PrEP, we have an ethical duty to do so.

“Furthermore, over the course of their lifetime the treatment of those 19 men will cost the NHS nearly £7 million. So the financial argument is clear, as is the ethical one. PrEP needs to be available on the NHS as soon as possible for all those who need it.”

Truvada is currently only available to people in the UK taking part in the PROUD study.

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