Windy City Media Group Frontpage News

THE VOICE OF CHICAGO'S GAY, LESBIAN, BI, TRANS AND QUEER COMMUNITY SINCE 1985

home search facebook twitter join
Gay News Sponsor Windy City Times 2023-12-13
DOWNLOAD ISSUE
Donate

Sponsor
Sponsor
Sponsor

  WINDY CITY TIMES

HIV drugs can prevent infection
by Bob Roehr
2010-12-01

This article shared 4056 times since Wed Dec 1, 2010
facebook twitter google +1 reddit email


HIV drugs can do a remarkable job of suppressing high viral loads to undetectable levels, but can they prevent that infection in the first place? Most people thought that they could in theory but there was no proof of that … until now.

Results from the Preexposure Prophylaxis Initiative ( iPrEx ) Trial found that drugs could reduce new infections by 43.8 percent in the high-risk men who have sex with men ( MSM ) and transgender persons in the study. It was published in the New England Journal of Medicine Nov. 23.

The $43.6-million trial enrolled 2,499 participants at 11 sites on four continents, including San Francisco and Boston in the United States. Despite the fact that MSM are much more likely to be infected with HIV—they are more than half of those infected in the US and in the broader epidemic of sub-Saharan Africa they are at least four times as likely as their heterosexual counterparts to be infected with the virus—this is the first large biochemical prevention study conducted in MSM.

Participants were randomized to receive once a day dose of either Truvada, a single pill containing the drugs emtricitabine and tenofovir, or placebo, essentially a sugar pill with no active ingredients. They also received counseling on HIV prevention at every meeting with the study team. The analysis was based on a median of 1.2 years on the drug.

Of the first 100 people to become infected with HIV, 64 were receiving placebo ( an annual infection rate of about 4 percent ) and 36 were on Truvada. The 43.8 percent rate of protection was no home run but within the same ballpark as the protection seen in other recent prevention trials; the vaginal microbicide trial of tenofovir gel in African women ( 39 percent ) and a vaccine trial in Thailand ( 31 percent ) .

Adherence

Digging deeper, the researchers found that adherence was a very important part of the equation. The men who took at least half of their doses had 50.2 percent fewer infections; those who took at least 90 percent of their medication had 72.8 percent fewer infections. Even the best drugs will not work if people don't take them as they should.

Robert Grant, M.D., is a researcher at the Gladstone Institute at the University of California San Francisco and the principle investigator of the study. He said they asked participants to report how often they took their pills, but because people often are "optimistic" in their recall, and sometimes report what they think researchers want to hear, the study also tested for levels of the drug in the blood of those who became infected.

"No drug was detected in 91 percent; the other 9 percent had detectible levels inside blood cells that were very low. The absence of drug in the blood is probably due to people not taking the drug, which could explain all of the infections that did occur" in that group, Grant said.

The association between adherence and the level of protection was similar to what was seen in the microbicides trial. People who most closely used the product as intended had the best results. Cutting corners gave HIV an opportunity that it quickly exploited.

Reactions

"The iPrEx study results are extreme important and provide strong evidence that PrEP [ preexposure prophylaxis ] can reduce HIV acquisition among a segment of society disproportionately affected by HIV/AIDS," said Anthony Fauci, MD, director of the NIH National Institute of Allergy and Infectious Diseases. It provided $27.8 million toward the study.

He emphasized that despite this good news, "correct and consistent use of condoms and a reduction in the number of sex partners still remain the most effective ways to protect yourself from HIV infection."

"This is great news," said Thomas J. Coates, Ph.D., a leading international HIV prevention researcher at the University of California Los Angeles David Geffen School of Medicine. "But if it would have been any lower, I would have been devastated."

University of Pittsburgh HIV prevention researcher Ronald Stall, Ph.D., called the results "very good news for gay men and other populations at high risk of HIV transmission." It also points to the continued need for better behavioral interventions to support adherence.

Money

Gilead Sciences manufactures Truvada and supported the iPrEx study by providing all of the drugs used. The company said it "will be working with the appropriate regulatory agencies to determine if data from this study warrant inclusion in the prescribing information for Truvada."

While doctors can prescribe drugs for "off label" use that the FDA has not approved, and some already prescribe Truvada for prevention, health insurance companies generally only reimburse for the use indicated on the label of the drug.

Adding a prevention indication to the drug label likely will require additional trials in MSM and other populations, particularly with regard to preventing vaginal transmission of HIV. Some of those studies already are underway.

"The big conundrum right now is what does it mean for practice?" Coates said the response was not sufficiently great to signal immediate widespread adoption of this approach as a prevention intervention, particularly given issues of cost.

The retail price of the drug in the United States is about $14,000 a year, while the NIH pharmacy purchases it for about $5,000 a year, Fauci said.

In developing countries, generic versions of Truvada can be purchased for as little as 40 cents a day, according to Grant. However, those are the same places where more than half of the people already infected with HIV, who meet guidelines to begin treatment, cannot do so because of the cost. It is unlikely that public health officials will devote scarce resources to Truvada when a condom will do the same job much more cheaply.

Furthermore, an international survey of more than 5,000 participants, to be released next week by the Global Forum on MSM & HIV, found that more than half of MSM worldwide do not have access to basic HIV prevention and treatment services. Adding PrEP to the mix will be a challenge.

The paper "Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men" is freely available from the New England Journal of Medicine at www.nejm.org/doi/full/10.1056/NEJMoa1011205.


This article shared 4056 times since Wed Dec 1, 2010
facebook twitter google +1 reddit email

Out and Aging
Presented By

  ARTICLES YOU MIGHT LIKE

Gay News

HIV criminal laws disproportionately impact Black men in Mississippi 2024-02-21
--From a press release - A new report by the Williams Institute at UCLA School of Law finds that at least 43 people in Mississippi were arrested for HIV-related crimes between 2004 and 2021. Half of all arrests in the state ...


Gay News

'West Side Story' gets a sex-positive spin with new burlesque show 2024-02-19
- In partial observance of National Condom Day, which was Feb. 14, Los Angeles-based AIDS Healthcare Foundation (AHF) presented A West Side Story Burlesque at the Harris Theater for two hour-long performances on Feb. 17. The show, ...


Gay News

$200,000+ raised at AIDS Foundation Chicago's World of Chocolate Fundraiser to fight HIV/AIDS 2024-02-13
--From a press release - (Chicago, IL) More than 950 guests gathered at Chicago's famed Union Station (500 W. Jackson) for Chicago's Sweetest Fundraiser, AIDS Foundation Chicago's (AFC), World of Chocolate on Friday, February 9. ...


Gay News

Munar prepares to step away from Howard Brown leadership 2024-02-11
- After 10 years of leadership at Howard Brown Health, President and CEO David Ernesto Munar has decided to step down from his post on Feb. 29. Munar, who'd previously been president and CEO of AIDS Foundation ...


Gay News

National Black Justice Coalition commemorates National Black HIV/AIDS Awareness Day 2024-02-07
--From a press release - WASHINGTON — Today, Feb. 7, marks National Black HIV/AIDS Awareness Day (NBHAAD). In commemoration, Dr. David J. Johns, CEO of the National Black Justice Coalition (NBJC), a leading Black LGBTQ+/same-gender ...


Gay News

NATIONAL Wis. report, gender dysphoria, HIV research, Stonewall exhibit, gay CEOs 2024-01-19
- A new annual report from Wisconsin's Office of Children's Mental Health shows that the state's minors—especially girls, children of color and LGBTQ+ youth—continue to struggle with anxiety, depression and thoughts ...


Gay News

WORLD Activist honored, marriages in Estonia, Madrid law, trans sports item 2024-01-05
Video below - The National AIDS Commission (NAC) recently honored Caleb Orozco—a leading figure in the fight for LGBTQ+ rights in Belize—for his instrumental contributions to the national HIV response, BNN reported. According ...


Gay News

SAVOR World of Chocolate, Jaleo and 'Superhot' 2023-12-31
- World of wonder: I am excited to announce that I will be a judge at AIDS Foundation Chicago's World of Chocolate fundraiser! Join me in sampling delicious chocolate from local chefs and help support a great ...


Gay News

PASSAGES Frankie Franklin-Foxx 2023-12-18
- Frankie Franklin-Foxx (born Waverlynn Franklin), a resident of Chicago's North Side, passed away peacefully Dec. 13 at St. Francis Hospital in Evanston. She was 68. Born at Cook County Hospital, Frankie graduated from South Shore High ...


Gay News

NATIONAL Dr. Rachel Levine, World AIDS Day, trans deaths, Philly bar art 2023-12-08
- United States District Court for the Northern District of Alabama Liles C. Burke ruled that emails and other records from U.S. Assistant Secretary for Health Dr. Rachel Levine are relevant to a lawsuit challenging Alabama's ban ...


Gay News

STRUT marks World AIDS Day with 14th Annual Fashion Show 2023-12-05
- On Dec. 3, John Fleming and Madman Productions presented the 14th annual STRUT fashion show at Joe's on Weed Street, 940 W. Weed St. As in previous years, the standing room only show was a fundraiser, ...


Gay News

World AIDS Day commemorated at AIDS Garden Chicago 2023-12-03
- On the rainy morning of Dec. 1, Chicago Parks Foundation and the AIDS Garden Chicago Board of Directors hosted a World AIDS Day commemoration at AIDS Garden Chicago, just south of Belmont Harbor on the Lakefront. ...


Gay News

GLAAD marks World AIDS Day with launch of global resource hub, new HIV report 2023-12-01
--From a press release - New York, New York — Friday, Dec. 1 — GLAAD marked World AIDS Day this year by sharing the results of its fourth annual State of HIV Stigma Report, a national survey among U.S. adults measuring ...


Gay News

Wrightwood 659 to present 'Daniel Goldstein: The Marks We Leave Behind' on World AIDS Day 2023-11-29
- (CHICAGO, Nov. 29, 2023) —Alphawood Exhibitions will present Daniel Goldstein: The Marks We Leave Behind, an exhibition of works from the San Francisco-based artist & HIV/AIDS activist's iconic "Icarian Series," ...


Gay News

WTTW doc chronicles the activism of Danny Sotomayor 2023-11-03
- Practically everything the late Chicago AIDS activist Danny Sotomayor did was "a fight." So says fellow activist Victor Salvo in the new WTTW documentary The Outrage of Danny Sotomayor, which is part of the station's Chicago ...


 


Copyright © 2024 Windy City Media Group. All rights reserved.
Reprint by permission only. PDFs for back issues are downloadable from
our online archives.

Return postage must accompany all manuscripts, drawings, and
photographs submitted if they are to be returned, and no
responsibility may be assumed for unsolicited materials.

All rights to letters, art and photos sent to Nightspots
(Chicago GLBT Nightlife News) and Windy City Times (a Chicago
Gay and Lesbian News and Feature Publication) will be treated
as unconditionally assigned for publication purposes and as such,
subject to editing and comment. The opinions expressed by the
columnists, cartoonists, letter writers, and commentators are
their own and do not necessarily reflect the position of Nightspots
(Chicago GLBT Nightlife News) and Windy City Times (a Chicago Gay,
Lesbian, Bisexual and Transgender News and Feature Publication).

The appearance of a name, image or photo of a person or group in
Nightspots (Chicago GLBT Nightlife News) and Windy City Times
(a Chicago Gay, Lesbian, Bisexual and Transgender News and Feature
Publication) does not indicate the sexual orientation of such
individuals or groups. While we encourage readers to support the
advertisers who make this newspaper possible, Nightspots (Chicago
GLBT Nightlife News) and Windy City Times (a Chicago Gay, Lesbian
News and Feature Publication) cannot accept responsibility for
any advertising claims or promotions.

 
 

TRENDINGBREAKINGPHOTOS






Donate


About WCMG      Contact Us      Online Front  Page      Windy City  Times      Nightspots
Identity      BLACKlines      En La Vida      Archives      Advanced Search     
Windy City Queercast      Queercast Archives     
Press  Releases      Join WCMG  Email List      Email Blast      Blogs     
Upcoming Events      Todays Events      Ongoing Events      Bar Guide      Community Groups      In Memoriam     
Privacy Policy     

Windy City Media Group publishes Windy City Times,
The Bi-Weekly Voice of the Gay, Lesbian, Bisexual and Trans Community.
5315 N. Clark St. #192, Chicago, IL 60640-2113 • PH (773) 871-7610 • FAX (773) 871-7609.