Wednesday 6 August 2008

New York Times Examines Research Efforts Into Pre-Exposure Prophylaxis


By the middle of next year, more the great unwashed from about the humankind will be enrolled in trials to test pre-exposure prophylaxis as an HIV prevention method than in trials for HIV vaccine candidates or microbicides, according to a report released Sunday by the AIDS Vaccine Advocacy Coalition at the opening of the XVII International AIDS Conference in Mexico City, the New York Times reports. After "bleak findings" from trials testing other HIV prevention methods, including microbicides and HIV vaccines, many HIV/AIDS experts have said that PrEP is the most bright research in HIV prevention, the Times reports.

Initial findings from the trials could be useable as early as future year. The trials ar testing whether the antiretroviral tenofovir can buoy be used alone or in combination with the antiretroviral emtricitabine to forestall HIV transmitting. The trials also take aim to establish whether it is safe for HIV-negative people to take the drugs and what effect PrEP has on people who contract HIV patch taking the drugs.

Up to 15,000 people -- including men wHO have gender with hands; heterosexual work force and women; and discordant couples, in which one partner is HIV-positive and the other is HIV-negative -- in Botswana, Brazil, Ecuador, Kenya, Malawi, Peru, South Africa, Tanzania, Thailand, Uganda and the U.S. are expected to be enrolled in the trials by mid-2009. USAID, CDC and NIH are providing partial funding for all of the trials, patch the Bill & Melinda Gates Foundation is providing support for two of the trials, the Times reports.

According to AVAC, even if PrEP is proven successful, it will need to be combined with other prevention measures, including safer sex practices and role of white needles.

In addition, the findings are likely to rear additional questions, such as whether pickings PrEP just before sexual contact tin can be effective in preventing HIV transmission, the report said (Altman, New York Times, 8/4).

The report also identifies five priority issues for PrEP:
Ensuring that current trials have the best chance of producing data to determine the next steps;


Identifying and investing in additional research on PrEP;


Planning for optimal usage of PrEP;


Preparing for global procurement and delivery of PrEP; and


Providing adequate funding (AVAC liberation, 8/3).


"We cannot wait for the work results to begin to prepare for the optimum use and delivery of PrEP," Pedro Goicochea, an investigator for a PrEP study in Ecuador and Peru, aforesaid. He added, "Instead we should await ahead to consider all of the possible outcomes of these trials and make real plans for making PrEP available to those wHO can benefit from it as quickly and safely as possible if it is proven effective" (New York Times, 8/4).

AVAC Executive Director Mitchell Warren added that the HIV/AIDS research community "cannot shy off from discussing issues such as potentiality drug resistance, the trouble of adhering to a once-a-day pill regimen for people world Health Organization are [HIV-negative] or the cost of providing PrEP," adding that the news report "lay[s] the groundwork for these important discussions" (AVAC vent, 8/3).

The reputation is uncommitted online (.pdf).

Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference.


Reprinted with kind permission from http://www.kaisernetwork.org. You keister view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for electronic mail delivery at http://www.kaisernetwork.