July 28, 2014
Study on Intermittent Dosing of PrEP Suggests High Adherence
Preliminary results from the pilot phase of a study of an intermittent dosing strategy for Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) have suggest that a high proportion of the participants are adhering well, aidsmap reports. Researchers from the French IPERGAY study, which recruited 153 men who have sex with men (MSM) to receive Truvada or a placebo, presented their findings at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia. Full trial results are expected in late 2016.
Colloquial French often uses the prefix “hyper-,” pronounced “eeper,” as a superlative. In the French alphabet, the letter “i” is pronounced like an English “e.” So spoken out loud, “IPERGAY” translates to “really gay.”
In a structured take on what has been called “disco dosing,” the researchers instructed the participants to take two PrEP pills two to 24 hours before sex and another 24 hours later and yet another 24 hours after that. The participants were prescribed enough Truvada to take the drug daily.
The men reported a median two acts of anal intercourse per week and an average of 10 partners in two months.
The investigators studied the adherence of the first 129 men to be randomized between February 2012 and February 2013. Fifty-three percent reported in a self-interview that they were taking all the doses according to schedule. During quarterly in-person interviews, 76 percent of them said they had taken PrEP the last time they had sex, with 11 percent reporting taking Truvada “often.” Pill counts showed that participants were taking about 15 Truvada per month. Four men reported taking the drug daily.
Blood plasma tests showed that between 82 percent and 91 percent of the participants had tenofovir in their blood and 75 percent to 84 percent had emtricitabine—the two antiretrovirals (ARV) in Truvada. The test can detect the medications in the blood for up to seven days after they are taken, so this suggests that about 80 to 85 percent of the men had taken Truvada within a week of being tested.
In the placebo arm, 4 percent to 6 percent had detectable levels of both drugs. Half had taken post-exposure prophylaxis (PEP), which includes Truvada along with another ARV. (The study permitted this.) The researchers speculate that others in the placebo group may have taken Truvada “informally.”
To read the aidsmap story, click here.
To read the conference abstract, click here.
To read a POZ feature article about circumcision in Africa and skepticism surrounding the public health effort in this regard, click here.
Search: PrEP, pre-exposure prophylaxis, Truvada, tenofovir, emtricitabine, IPERGAY, AIDS 2014, 20th International AIDS Conference, intermittent dosing, disco dosing, adherence.
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