A small study of pre-exposure prophylaxis (PrEP) among young gay men in Chicago was able with some struggle to recruit willing participants, but it found there was a marked discrepancy between their reported and their actual adherence to the medication, aidsmap reports. The study's findings echo recent disappointing results from the VOICE trial among African women, which was unable to design PrEP modalities appealing enough to lead to high adherence among that population.

Publishing their results of their placebo-controlled study in the Journal of Acquired Immune Deficiency Syndromes, researchers studied 58 gay men, most of them African American, Hispanic or mixed race, between the ages of 18 and 22 who had all reported unprotected anal intercourse during the past year. They divided the men into three study groups: One received once-daily Truvada (tenofovir/emtricitabine); a second received a placebo; and a third received neither medication nor placebo, but, like the other groups, attended a clinic each month where they could receive safer-sex counseling in addition to health monitoring. All participants received a group-based behavioral intervention.

According to self-reports, participants adhered to PrEP at a rate of 72 percent for the first two months of the study and at 80 percent in the subsequent four months. Drug-level monitoring contradicted this assertion: Adherence began at about 50 to 60 percent in the first three months of the study and then declined to 20 percent at the six-month point. Due to the fact that the drug-level test could only detect the medication taken during the previous 48 hours, however, it is feasible that participants took PrEP intermittently and that the screens could have failed to detect total usage.

The study authors concluded that their results show that it is feasible to establish a study of gay youth taking PrEP and that group interventions given with counseling and HIV testing found high acceptance among the participants. However, their data draw into question how to better design such a study to encourage high adherence to PrEP.

To read the aidsmap story, click here.