AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #460 - Recent developments in HIV pre-exposure prophylaxis (PrEP): from evidence to implementation
Authors: Presenting Author: Dr. Jeanne Marrazzo - University of Washington
Additional Authors:
Aim: Despite remarkable advances in antiretroviral treatment, infection with HIV-1 is still incurable, and current prevention strategies including abstinence, condom use, and male circumcision are only partially effective. To date, four clinical trials have provided promising data that pre-exposure prophylaxis (PrEP) using antiretroviral agents (ARV) may offer a promising strategy. The CAPRISA 004 study demonstrated that periocoital vaginal insertion of 1% tenofovir gel significantly reduced women’s risk of acquiring HIV-1. The iPrEx study demonstrated that daily oral tenofovir-emtricitabine (TDF/FTC) reduced the risk of HIV-1 acquisition in men who had sex with men by a similar magnitude. The Partners in Prevention PrEP Study demonstrated efficacy of nearly 62-73% with daily oral TDF or TDF/FTC among the HIV-negative partner of serodiscordant couples, who generally reported excellent adherence. Daily oral TDF/FTC was also effective among heterosexual adults in the Botswana-based TDF2 Study. While the findings of these studies have infused much-needed energy into the field of HIV prevention, many questions remain to be answered before PrEP can be widely implemented across all populations at risk for HIV-1, particularly since one study (FEM-PrEP) of daily oral TDF/FTC in women at high risk for HIV acquisition was recently halted for futility. In this symposium, we will review the current status of PrEP as a means to prevent HIV-1 acquisition.
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