San Francisco city officials are gearing up to offer pre-exposure prophylaxis (PrEP) to men who have sex with men (MSM) through a demonstration project set to begin in early 2012, according to a September 8 news report published by the Bay Area Reporter (BAR). 

Through the demonstration project, which is being conducted in collaboration with the National Institutes of Health, up to 300 MSM at high risk for contracting HIV will be enrolled. City Clinic will administer the program, while Magnet, the gay men's health center in the city's Castro neighborhood, will help identify suitable participants for the study.

“We are anticipating we will be the first municipality to implement a PrEP demonstration project, and things are moving forward toward that goal,” Grant Colfax, MD, the city's director of HIV prevention, told the BAR. “We are hoping the demo project would be implemented in the first quarter of 2012.”

The rollout of PrEP, which involves taking one Truvada (tenofovir plus emtricitabine) tablet daily, has been highly controversial, the news report acknowledges. It says that some HIV prevention officials are worried that gay men will use it in order to engage in risky sexual practices. Others, the report adds, are concerned about how a daily regimen of powerful drugs will affect these men's health later in life.

According to Magnet director Steve Gibson, the demonstration project will help answer several questions about this mode of treatment as prevention, including how MSM will adopt using PrEP and how providers will ensure that lower-income MSM, including men of color, have access to it.

San Francisco is expected to become the first city in the country to offer Truvada PrEP to at-risk MSM.