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With Accessible, Affordable PrEP, Low HIV Infection Rates are Maintained

A new Australian study shows the infection rate was 1.61 cases per 1000 people per year over a 3 year study period in participants with access to the therapy.

Pre-exposure prophylaxis (PrEP) therapy helped to maintain low HIV infections rates over a 3 year period in men who have sex with men (MSM) in an observational study that was performed in New South Wales, Australia.

Previous studies had shown PrEP being effective at HIV prevention up to 18 months, but this trial with the follow-up lasted 36 months.

“Our analysis, the longest and largest study of its kind to date, provides important insights into the longer-term benefits of PrEP, demonstrating that it remains highly effective in preventing HIV among men who have sex with men in a real-world setting,” Professor Andrew Edwin Grulich from the University of New South Wales, one of the study’s co-authors, said.

These findings were published today in The Lancet HIV journal.

The study was conducted between March 2016 and April 2018, with 9596 participants recruited for it. Participants were given a 3 months’ supply of PrEP at least once. Participants were followed up to March 31st 2019, and 9520 (99%) were administered 1 follow-up HIV test. Participants had an average age of 34 with (99%) 9455 being male and the rest (1%) were transgender.

“Despite adherence to PrEP treatment declining over time among study participants, with the average medication possession ratio (MPR) reducing from 0.93 to 0.64 over the course of the first two years of follow-up, infections remained low throughout the study,” investigators reported.

The investigators did report there was a slight increase in HIV infections after the first year. In year 1, there were 1.09 infections per 1000 people; in year 2, there were 2.10 infections per 1000 people, and there were 2.18 infections per 1000 people in year 3.

In this study, PrEP had been provided for free up until year 3 when participants were required to pay a monthly co-payment of around $AUD40 (approximately US$30 or £22).The investigators remarked about the ability to have access to PrEP in order to keep HIV incidence rates low.

“There are still many global settings where PrEP is not widely utilized or accessible. We urge policymakers around the world to recognize that access to affordable PrEP has reduced HIV transmission in New South Wales and apply it on a global scale,” Grulich said.