PROUD Study: PrEP Reduced HIV Transmission by 86%

At the Conference on Retroviruses and Opportunistic Infections in Seattle, WA, scientists from the UK reported results from a research indicating that taking an antiretroviral medicine everyday is very effective at protecting men who have sex with men from HIV infection.

Pre-exposure prophylaxis (PrEP) was identified to decrease the danger of infection by 86% for this group while in the PROUD study (Pre-exposure Option for reducing HIV in the UK: immediate or Deferred). The results were so pronounced that a group of individuals who had been deferred access to PrEP were provided the treatment ahead of schedule.

“These outcomes are very interesting and show PrEP is highly effective at preventing HIV infection in the real world,” states lead researcher Prof. Sheena McCormack. “Concerns that PrEP would not work so well in the real world were unfounded. These outcomes show there is a require for PrEP, and offer hope of preventing the epidemic among men who have sex with men in this nation.”

For the study, the investigators used the antiretroviral Truvada, a medicine that has earlier been proven to decrease the incidence of HIV infection in placebo-controlled studies. In this new research, the investigators required to identify whether the drug would be similarly successful in a real-world situation.

Concerns such as whether PrEP would affect sexual risk behavior and how cost-effective the therapy would be would also be addressed by the study.

Starting in 2012, overall of 545 individuals were enrolled from 13 sexual health clinics throughout England. Individuals were randomly allocated into two groups – 276 individuals started getting PrEP immediately, and the other 269 would get PrEP after 12 months.

A overall of 22 HIV infections took place among the individuals during the 1st year of the study. Of these, 3 were in the group getting PrEP and 19 were in the group whose access to PrEP was delayed. The investigators compute that this gave the PrEP group an HIV incidence of 1.3 per 100 person-years, in comparison with 8.9 per 100 person-years in the deferred group.

In October 2014, the individuals who had yet to start PrEP were to be provided the drugs earlier than planned, right after a recommendation from the Independent Data Monitoring Committee dependent on an interim research of the data that had been accumulated up till that point.

PrEP ‘could have a significant impact in protecting against HIV infection’

Behavioral data were also gathered throughout the study. At the conference, the scientists recommended that sexual risk behavior was unchanged by PrEP. Reported condom use appeared identical both before and during the research, and no considerable variations in the rates of STI infection between groups were noticed.

Dr. Des Walsh, head of Infections and Immunity at the Medical Research Council (MRC) in the UK, states that HIV continues to be a serious public health issue and that new methods are needed to tackle what he explains as an “epidemic.”

“The PROUD research addresses this very essential issue and shows encouraging outcomes that a relatively straightforward intervention dependent on existing treatments – PrEP – could have a main effect in preventing HIV infection,” he claims.

The outcomes of the research are now to be presented to a peer-reviewed journal. In addition, cost-effectiveness studies are being performed to see whether antiretrovirals for PrEP must be commissioned for use by the British National Health Service.

Dr. Richard Gilson, a principal investigator for the PROUD research, works at a sexual health clinic in central London in the UK. He feels that there are a lot of high-risk men who have sex with men who would be eager to take PrEP tablets consistently to decrease their risk of infection:

“This will not suit everybody, and may not be required indefinitely, but for at least some people for some of the time it must be regarded as an essential additional measure that will assist to decrease the persistently high rate of new infections that we are continue to seeing.”