A recent UCLA study shows that using pre-exposure antiretroviral medication may decrease the rates of contracting human immunodeficiency virus (HIV) even though there is still a high rate of contracting sexually transmitted infections (STI).
The study involved distributing the medication from clinics based within three metropolitan areas that have high HIV rates. These clinics typically serve men who have sex with men (MSM), making these areas the most promising ones for pre-exposure prophylaxis (PrEP). MSM make up over two-thirds of the nation’s new HIV infections.
“Overall, the news concerning PrEP dissemination is good, but there are sobering lessons,” Raphael Landovitz, of the David Geffen School of Medicine at UCLA, said. “Realizing the benefits of PrEP requires an optimal cascade of events that is remarkably similar to the Gardner Cascade of engagement in care for those infected with HIV. The so-called PrEP cascade requires identification of at-risk individuals, promotion of interest and knowledge of PrEP, linkage to PrEP-knowledgeable clinics, and PrEP initiation, persistence and adherence. The benefits of PrEP will only fully be realized when we can identify ways of successfully moving persons at a high risk of HIV infection through this cascade.”
Previous randomized clinical trials proved that PrEP is effective in protecting people from HIV infections, but there is not much known about the sexual practices of the participants, the adherence to the PrEP regimen, and the general efficacy of PrEP among STI as well as clinics based in MSM communities.
