PrEP: Preventative HIV drug highly effective, study says

A groundbreaking drug designed to thwart HIV infection has exhibited significant real-world effectiveness, according to a comprehensive study involving 24,000 participants across England. Described as “reassuring,” the findings underscore PrEP’s (pre-exposure prophylaxis) potential as a highly successful preventative treatment.

Conducted by the UK Health Security Agency (UKHSA) in collaboration with the Chelsea and Westminster Hospital NHS Foundation Trust, the PrEP Impact Trial is the largest-ever real-world study of its kind. Spanning 157 sexual health clinics and funded by NHS England, the trial unfolded between October 2017 and July 2020.

The study revealed that PrEP, even when accounting for inconsistent or incorrect use in everyday life, reduced the likelihood of HIV transmission by approximately 86%. This result aligns with earlier clinical trials suggesting a 99% efficacy when used correctly.

Dr. John Saunders, a sexual health and HIV consultant involved in the study, highlighted the trial’s importance in showcasing PrEP’s protective effects at a large scale. He emphasized that the trial, conducted through routine sexual health services, provides valuable insights into how the drug is utilized.

The Terrence Higgins Trust, an HIV charity, applauded the study’s publication but emphasized the need for increased awareness and access to PrEP, especially among certain minority groups. Debbie Laycock, head of policy, stressed the importance of making PrEP available in pharmacies and online to reach a broader audience.

The study not only confirmed the clinical success of PrEP but also shed light on user behavior. Dr. Saunders noted that understanding prescription trends and user demographics would aid efforts to encourage more people to adopt PrEP.

Participants in the trial, such as Harry Dodd from North London, expressed the empowering impact of PrEP, eliminating the fear of HIV transmission and fostering confidence in relationships. Dodd believes PrEP can contribute to destigmatizing HIV by normalizing its use.

While acknowledging the prevalence of PrEP use among gay and bisexual men, Dr. Saunders emphasized its potential benefits for a diverse range of individuals, including straight women.

PrEP, containing the HIV treatment drugs tenofovir disoproxil and emtricitabine, operates by preventing HIV entry into the body and inhibiting replication. It can be taken as a daily pill or on an “event” basis before sexual intercourse.

The decision to make PrEP widely available on the NHS in England in 2020 was influenced by earlier findings from the PrEP Impact Trial and earlier clinical trials. The study’s results, published in Lancet HIV, affirm the drug’s effectiveness and its pivotal role in the government’s goal of zero HIV transmissions by 2030. The NHS continues to offer free access to PrEP through sexual health services.

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