Gay and bisexual men are very receptive to using Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) when it's offered in a health care setting and is part of a component of a comprehensive HIV prevention program, Medscape reports. Albert Liu, MD, MPH, of Bridge HIV at the San Francisco Department of Public Health, presented findings from the PrEP Demonstration Project at the 9th International Conference on HIV Treatment and Prevention Adherence in Miami.

A demonstration project looks at real-world use of a therapy, as opposed to studying its use within the strict confines of a controlled trial. The researchers recruited gay and bisexual men seeking services at two sexually transmitted infection clinics, in San Francisco and Miami, as well as at a community health center in Washington, DC. Interest in the community was high: During the first half of the six-month enrollment period, 30 percent of the potential participants referred themselves, and by the second half of the enrollment period that figure was 50 percent.

All told, there were 921 potential participants who either self-referred or were approached at the respective demo project sites. A total of 364 of them declined to participate, while 557 entered the study.

The men took Truvada for 48 weeks. Tests taken after four weeks of treatment to measure the level of tenofovir in the blood of a random sample of 136 participants showed that 77 percent of them were taking at least four doses each week. Research has shown that this is the minimum adherence required to achieve a more than 90 percent reduction in the risk of acquiring HIV. (Note: This is not to say that starting Truvada and taking the drug for four days is sufficient to reach that level of protection.)

In addition, the researchers intermittently tested 90 of the participants for tenofovir levels throughout the study and found that a majority were taking four or more pills each week, suggesting that drug adherence did not dissipate over time.

Liu stressed to Medscape that these results are early and that it is vital to continue to follow the study group in search of greater insights.


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