New PrEP Efficacy Data

Fenway Health in Boston has released an analysis of patient data indicating that PrEP is an effective form of prophylaxis against HIV infection. They presented the analysis in an abstract at the HIV Research for Prevention (HIVR4P) meeting in Madrid, Spain on October 23, 2018. Founded in 2014, HIV Research for Prevention is the world’s only scientific meeting dedicated exclusively to biomedical HIV prevention, including vaccines, antibodies, microbicides, treatment as prevention, pre-exposure prophylaxis (PrEP) and new forms of HIV prevention.

“We found that between 2012 and 2017, almost 4,000 patients initiated PrEP at Fenway Health, one of the largest groups in a single US health care system. The rate of new HIV infections was significantly decreased among patients prescribed PrEP compared to those who did not access PrEP,” said Kenneth H. Mayer, MD, Medical Research Director and Co-Chair of The Fenway Institute at Fenway Health and lead author on the abstract.

Of the 16,128 patients who underwent HIV testing at Fenway Health at least twice between 2012 and 2017, 25 percent, or 3,965, were prescribed PrEP. While 1.34 percent of the patients who were not using PrEP seroconverted, only 0.43 percent of those who were ever prescribed PrEP and 0.13 percent of those on a current PrEP regimen at the time of infection seroconverted.

“Most of the few patients who became infected after being prescribed PrEP had discontinued it because of either insurance issues, challenges in engaging in care, changes in their risk perception, or concerns about stigma. The study found that PrEP is effective in decreasing HIV incidence in a primary care setting, but social and behavioral issues need to be addressed to optimize its impact,” said Dr. Mayer. Only twelve of them had discontinued taking PrEP more than a month before becoming infected. Only five patients who reported recent PrEP use became infected, indicating that when PrEP is used regularly as prescribed, it greatly reduces an individual’s chances of acquiring HIV.

The patients who were part of this analysis were all regular primary care patients at Fenway Health, a health center that has long-established expertise in caring for sexual and gender minorities. Thus, these results may not be the same elsewhere; that is, while the findings of this analysis demonstrate the effectiveness of PrEP among this particular patient population, the efficacy of wider application of PrEP will require much wider study, including addressing multiple behavioral and social issues impacting those who could benefit from PrEP.

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—Reporting by Hank Trout

Hank Trout, Editor at Large, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a thirty-eight-year resident of San Francisco, where he lives with his fiancé Rick. Follow him on Twitter @HankTroutWriter.