Results from the iPrEx clinical trial showed significant risk reduction of contracting HIV when participants used Truvada as a form of PrEP.
Who is doing the research?
The study is sponsored by the National Institute of Health (US) and has a number of international collaborators. Participants have been recruited from the United States, Thailand, South Africa and South America.
What is PrEP?
Pre-exposure prophylaxis (PrEP) is an HIV prevention method currently being explored in multiple studies. PrEP involves an HIV-negative individual taking antiretroviral drugs to reduce their risk of contracting HIV. PrEP can be taken in multiple forms including pills, topical gels or injections.
What is Truvada?
Truvada is an anti-HIV drug that combines two anti-HIV medications into one pill.
What is the iPrEx study?
iPrEx is an international study aimed at determining whether using Truvada can help prevent HIV acquisition in HIV-negative people. The study is looking specifically at MSM (men who have sex with men) populations.
What are the positive results?
The most positive result of the study is that the daily use of Truvada reduced the risk of contracting HIV by 44%. The daily use of Truvada in this study was shown to be safe and to have minimal side effects.
What are the concerns?
PrEP is not a substitute for condoms and there is a concern that people may view it as such. To date, nothing has proven to be as effective in preventing the spread of HIV as correct and consistent condom usage.
There is also a concern that people using Truvada as a form of PrEP may develop drug resistances that could reduce treatment options should they become HIV-positive.
The cost of this form of PrEP, should it become available, could also pose a major concern. Relative to other forms of prevention (e.g. condom use), Truvada is very expensive. In the United States and Canada the necessary dosage of Truvada for HIV prevention would cost approximately $800/month.
It should also be noted that this study looked specifically at MSM with receptive anal sex being the possible mode of transmission. This study doesn’t provide any information about the effectiveness (or safety) of using Truvada to prevent HIV transmission through vaginal sex or injection drug use.
How long until this form of PrEP is commercially available?
The iPrEx study is still in the clinical stage trial. Several more years of clinical trials remain in the study. If the method is proven effective, even after clinical trials are complete it could take several years before this form of PrEP could be made readily available.
For more on this study:
Truvada for HIV prevention – some good news but caution still needed, CATIE
iPrEx study official website
Truvada official website
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