Good News: No New HIV Infections; Bad News: 50% Had an STD after 12 months

There is worrisome as well as promising news from data released from a study of the use of Gilead Sciences’ HIV anti-retroviral medication, Truvada (tenofovir DF + emtricitabine), for pre-exposure prophylaxis (PrEP) to prevent HIV infection. The good news: of the 657 individuals in the study who actually went on PrEP the were NO HIV infections. The bad news: after 12 months of PrEP use, 50% of the PrEP users were diagnosed with an STD: 33% with a rectal STD, 33% with chlamydia, 28% with gonorrhea and 5.5% with syphilis. Equally worrisome, and perhaps reflected in the high incidence of STDs reported: there was a self-reported 41% decrease in condom use, despite the fact that FDA guidelines for use of Truvada as PrEP include continued condom use.

The study, Volk JE et. al. (2015) “… included all adult Kaiser Permanente members evaluated for PrEP from July 2012 (the date of FDA approval) through February 2015.” It culled 1,045 individual referrals from 170,000 adult members of the San Francisco Bay Area’s Kaiser Permanente health plan membership. 835 individuals had an in-person contact, leading to 801 people having an intake visit regarding possibly starting on PrEP. Of these 801 patients, 657 opted to go on PrEP, while 144 chose not to start PrEP, but remained part of the study.

“The fact that 50% of the 657 individuals on PrEP in this study contracted a sexually-transmitted infection after one year on PrEP suggests that this population is one of the highest-risk groups, and the most desirable to target for deploying prevention methods like pre-exposure prophylaxis,” said AHF President Michael Weinstein. “However, the STD incidence, coupled with the reported 41% decrease in condom use—despite FDA ‘black box’ guidelines advising continued use of condoms while on PrEP—suggests the significant limitation of relying solely on a medication-only approach to prevention.”

Limitations in fully analyzing the study data released include the fact that no demographic data were released: no racial or ethnic information on study participants, no economic data, nor ages of the individuals. The Bay Area is one of the wealthiest metropolitan areas of the county, with a median income of $63,024 according to the United States Bureau of the Census.

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 465,000 individuals in 36 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare.

AHFGed Kenslea, Senior Director, Communications+1.323.308.1833 work+1.323.791.5526 mobilegedk@aidshealth.orgorChristopher Johnson, Associate Director of Communications+1.323.960.4846 work+1.310.880.9913 mobilechristopher.johnson@aidshealth.org