When people were offered pre-exposure prophylaxis (PrEP) outside of traditional clinics as part of a sustainable East African study in community health, regardless of specific risk factors (look for) Research, new HIV Acquisitions were down 74%.
This is a valuable lesson for health care providers around the world, says Dr. Katherine Koss, associate professor of medicine for HIV, infectious diseases, and global medicine at the University of California, San Francisco.
“I’ve never seen PrEP expanded and delivered to the community at such a broad level,” said Corres during the International AIDS Conference 2020. “Providing PrEP in a more ubiquitous manner may reduce the incidence of lowering barriers for both men and women.”
The first part of SEARCH examining the impact of universal testing and access to HIV treatment shortly after diagnosis showed that the strategy resulted in a 30% reduction in the overall population of new HIV acquisition. I mean, just treatment Was not enough To end the HIV epidemic.
However, researchers have always known that “new HIV infections are likely.” HIV test Treatment, Kos said.
Therefore, the second part of the study was that PrEP was identified as tenofovir disoproxil fumarate. Emtricitabine (Tolvada, Gilead Sciences) — May further reduce HIV prevalence.
PrEP in the community
As part of the SEARCH study PrEP, a population-level test was conducted in adults and in health fairs, beaches, trading centers and other community sites in 16 rural communities in Kenya and in Uganda, as well as in participants’ homes. I discussed HIV risk. PrEP was given to people who had a relationship with people living with HIV, and who were determined to be at high risk of infection. Previously verified For those who did not meet the algorithms and their criteria but needed a prescription.
Of the 15,632 adults eligible for PrEP, 5,447 (35%) chose to take HIV prophylaxis.
The expedited registration protocol meant that people would receive a prescription at or shortly after screening. Participants were also tested for HIV antibodies in the community at weeks 4 and 12, and every 12 weeks thereafter. This continues until week 144.
HIV-negative adults, who were part of a larger SEARCH cohort the year before PrEP became available, served from the same community—as a control group.
Intermediate 60-week data show that the acquisition rate is 74% lower in PrEP than in controls (incidence ratio, 0.26; P = .01). In women, the acquisition rate was 76% lower (incidence ratio, 0.24; P = .04), and 40% lower in men (incidence ratio, 0.60; P = .54).
Koss reports that it was not a significant reduction for men, perhaps because few men were infected with HIV. A strong reduction in overall new HIV cases was associated with the use of PrEP by women. The number of female cases decreased from 1.52 to 0.40 per 100 person years.
Blood tests showed that 72% of people infected with HIV during the study period did not take PrEP tablets for at least 30 days before diagnosis.
“Making PrEP easier to access and community-based can be very powerful in the US,” Koss said.
“Allowing people to test HIV and start PrEP outside clinics and standard health facilities may help reach more people,” she said. Medscape Medical News.. “Many of the beneficiaries of PrEP may not need regular medical attention if they are healthy and young.”
When PrEP becomes available
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Easily available
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People pick it up, take it off, put it in their mouth, and they don’t get HIV.
The findings were welcomed by others in the field of HIV prevention.
“They’re great,” said Jared Baeten, MD, Deputy Dean of the School of Public Health and Professor of International Health, Medicine, and Epidemiology at the University of Washington in Seattle. He was involved in Partner PrEP, A study of PrEP use in couples with mixed HIV status, Partner demonstration project,and Want, Study of Dapivirin Rings for HIV Prevention.
“These data provide real evidence that people will pick it up, remove it, put it in their mouth, and not get HIV when PrEP becomes available (when it’s readily available).” He said. Medscape Medical News..
In addition, they reveal something that has plagued US regulators and clinicians.
Earlier studies on the use of PrEP by single women were discontinued because participants were not taking the drug. Researchers were unable to demonstrate efficacy due to poor adherence. Since then, various trials, including Partners PrEP, have shown that PrEP works in women, but doubts remain, and women are “letting talks about PrEP end in a short time.”
“It shouldn’t be a problem anymore,” he said. “These findings should calm the question about how African women can benefit from PrEP.”
International AIDS Conference 2020: Summary OAC08. Announced on July 8, 2020.
