October 19, 2007

Pondering PrEP in a Mock Debate

At a conference earlier this month in San Diego, researchers staged a mock debate to discuss pre-exposure prophylaxis (PrEP), a potential new form of HIV prevention that would use existing HIV antiretroviral medications before sexual intercourse to prevent transmission (ebar.com, 10/18).

The debate—which played out in front of an audience of thousands at the annual meeting of the Infectious Disease Society of America—was between Robert Grant, a researcher at the University of California, San Francisco, and Ward Cates, president of Family Health International. While both support PrEP, Grant took a pro-stance, while Cates played the role of critic.

“People like sex,” said Grant. “People are sex connoisseurs, they like their sex just so. Other prevention concepts have not worked because people don’t use them because they alter sex in some way that people care about.”

Grant also pointed out the success that HIV medications such as Truvada have had success in suppressing transmission from mother to child and in couples trying to conceive.

Playing devil’s advocate, Cates warned that while laboratory tests in monkeys have yielded impressive results, there is very little human data on PrEP, and that HIV drugs for negative people may be too costly for resource-poor regions.

But a new study published today in the online journal PLoS One reveals that PrEP may cut new infections in sub-Saharan Africa by 74 percent in 10 years if used consistently.