Would you feel safer if you had a packet of pills on your bedside table that could protect you from HIV after exposure? A study presented at the European AIDS Conference found that a small group of men were able to take the pills appropriately as post-exposure prophylaxis (PEP) and that having them on hand decreased their anxiety.
PEP involves taking a series of pills following condomless sex or another route of exposure. It’s different from oral pre-exposure prophylaxis (PrEP), which involves taking Truvada (tenofovir disoproxil fumarate/emtricitabine) daily or before and after sex or Descovy (tenofovir alafenamide/emtricitabine) daily. PEP usually requires a several-day course of more antiretrovirals than PrEP. But crucially, it must be started within 72 hours of exposure for it to work.
Calling the approach PEP-In-pocket, or PIP, Matthew Clifford-Rashotte, of the University of British Columbia, and colleagues reviewed the charts of 43 people who’d received preemptive prescriptions for PEP at two HIV clinics in Toronto between 2017 and 2020 and had returned for a follow-up visit.
Participants were primarily gay men and had an average age of 36. Fifteen participants used PEP 27 times during that period. Nine out of 10 of those uses (89%) were deemed appropriate by the researchers, and no one missed an opportunity to use it. The inappropriate uses came when one man took the pills pre-emptively for an encounter that never happened; another took it for sex where a condom could have protected him.
What’s more, 12 months later, no one had acquired HIV, and one in five had transitioned from PEP to PrEP. And while 9% were lost to follow-up, the remaining 72% of participants still had the pills and reported that they were still using the PEP-in-pocket approach. The men also reported less risk behavior.
Of those who remained on PEP-in-pocket, 96% said having the pills at the ready had decreased their anxiety. And all of them said they would recommend it to a friend.
Click here to read the study abstract.