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HIV Incidence Remains Low With PrEP in Real-World Setting

Study of mainly gay or bisexual men shows low incidence of HIV, even when PrEP was mostly purchased rather than provided free

FRIDAY, July 2, 2021 (HealthDay News) — HIV incidence remains low over three years of follow-up among individuals at high risk of HIV receiving preexposure prophylaxis (PrEP), according to a study published online July 1 in The Lancet HIV.

Andrew E. Grulich, Ph.D., from the University of New South Wales in Sydney, and colleagues reported trends in HIV incidence over three years in individuals at high risk who were prescribed PrEP. Eligible participants were HIV-negative adults who were at high risk of infection as defined in local guidelines. A total of 9,709 participants were enrolled and 9,596 received PrEP, of whom 98.3 percent were gay or bisexual men.

The researchers found that from the first to the ninth quarter, the mean medication possession ratio (MPR) decreased from 0.93 to 0.64. Over 18,628 person-years, there were 30 HIV seroconversions, for an incidence of 1.61 per 1,000 person-years. In univariate analyses, increased HIV incidence was associated with being younger, living in a postcode with fewer gay men, reporting more risk behaviors at baseline, and having an MPR of less than 0.6. HIV incidence remained low at 2.24 per 1,000 person-years in the final year of the follow-up, when PrEP was mostly purchased rather than provided free by the study.

“There are still many global settings where PrEP is not widely utilized or accessible,” Grulich said in a statement. “We urge policymakers around the world to recognize that access to affordable PrEP has reduced HIV transmission in New South Wales and apply it on a global scale.”

Several authors disclosed financial ties to pharmaceutical companies, including Gilead Sciences, which funded the study.

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