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PrEP effective in preventing HIV acquisition in MSM and transgender women


 

FROM JAMA INTERNAL MEDICINE

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A total of 622 YBMSM – mean age of 23 years, 39% with high school or equivalent level of education, 79% of whom reported annual income of less than $20,000, and only half of whom were both HIV-negative and reported having health coverage – were enrolled, based on eligibility requirements that they self-identified as African American or black, were born male, were between 16 and 29 years of age, and reported oral or anal sex with a male within the 24 months prior to enrollment.

PrEP of daily oral tenofovir disoproxil fumarate and emtricitabine was administered between June 2013 and July 2014. Baseline levels of PrEP awareness – 40.5% of participants knew about PrEP, and 12.1% knew of someone who had used PrEP – remained unchanged significantly at follow-up. Just over 72% of participants were not infected with HIV during the study period; only 3.6% of these individuals had previously used PrEP prior to enrollment.

“Ongoing work should include scientific assessment of strategies to mobilize networks of YBMSM around PrEP as part of a comprehensive health care program. Concomitantly, efforts to mitigate the structural barriers that prevent PrEP uptake among YBMSM may greatly improve the public health effect potential of this promising HIV prevention intervention,” conclude the authors, led by Dr. John A. Schneider of the University of Chicago.

The Demo Study was supported by the NIH’s National Institute for Allergies and Infectious Diseases, National Institute for Mental Health, the Miami Center for AIDS Research, and the Gladstone Institute of Virology & Immunology–University of California, San Francisco. Gilead Sciences supplied the study drugs and support for pharmacokinetic and resistance testing. Dr. Liu disclosed leading other trials in which study drugs were supplied by Gilead Sciences, but no other conflicts of interest. Several other coauthors reported potential conflicts of interest.

The uConnect study was supported by the NIH’s National Institutes of Health. Neither Dr. Schneider nor any coauthors reported any potential conflicts of interest.

dchitnis@frontlinemedcom.com

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