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to Section One | to Arts & Entertainment
posted Friday, October 31 2014 - Volume 42 Issue 44
PrEP can be effective on intermittent basis, French study says
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PrEP can be effective on intermittent basis, French study says

by Mike Andrew - SGN Staff Writer

PrEP drugs are not only effective, a new French study says, but they can be effective at preventing HIV infections even if taken intermittently right before and after sex.

In fact, the study showed that PrEP meds were so successful, that lead researcher Jean-Michel Molina closed the randomized phase of the study early and put all his control group - who had been taking a placebo - on PrEP.

Molina's research team found a significant difference in incidence between the two groups with a 'very significant reduction' in the risk of HIV infection in the PrEP group. In fact, the reduction in HIV risk was described as 'much higher than the one observed in the iPrEx trial,' referring to a pioneer PrEP study in 2007 and 2008.

Molina's study, called IPERGAY, was run by the French national AIDS research institute, ANRS, and began in February 2012. The study researched the effects of PrEP in 400 volunteers in several French cities and in Montreal.

IPERGAY participants did not take PrEP daily, but only when they anticipated having sex. The regimen involved taking two pills of Truvada in the 24-hour period before anticipated sex and then, if sex took place, two separate one-pill doses in the two days following sex.

All participants were also offered a package of prevention measures including 'personalized and frequent' counseling, repeated HIV testing, screening and treatment for other sexually transmitted infections, hepatitis B vaccination, condoms and lubricant.

So-called 'on demand' PrEP extends the versatility of the prevention method and provides an alternative regimen to daily dosing. Critics of PrEP worry that patients will miss their regular daily dosage of Truvada and therefore believe they have protection against HIV infection when, in fact, they are at risk. Molina's findings suggest that worry may be misplaced.

'The biomedical concept of on-demand PrEP at the time of sexual exposure, in a broader prevention framework, is validated,' Molina said. 'We owe this to all trial volunteers without whom we could never have achieved these results.'

He also cautioned that 'condoms remain the cornerstone of HIV prevention. Combining all prevention tools that have proved to be effective will certainly allow us to better control the HIV epidemic.'

Professor Jean-François Delfraissy, Director of ANRS, commented, 'This is a major breakthrough in the fight against HIV. The results of the ANRS IPERGAY trial should change national and international recommendations for HIV prevention.'

The trial will continue on a non-randomized form for at least a year, because of the need to demonstrate that 'on demand' PrEP can have long-term benefit and to gather data on safety. The full results should be available early in 2015.

According to the World Health Organization, around 2.3 million people are infected with HIV every year.

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