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PrEP for Men at High Risk for HIV May Be Taken on Demand

Research suggests medication still works when taken before and after sex, instead of daily

TUESDAY, Dec. 1, 2015 (HealthDay News) — New research suggests that men at high risk for HIV can benefit from pre-exposure prophylaxis (PrEP) taken before and after sex instead of every day. The study was published online Dec. 1 in the New England Journal of Medicine to coincide with World AIDS Day.

Researchers assigned 199 participants to take a combination of emtricitabine and tenofovir disoproxil fumarate, while another 201 took a placebo. All the participants were gay and bisexual men at high risk of HIV infection, and they were told to take the pills two to 24 hours before sexual activity and afterward. The participants took the pills a median of 15 times a month, but an analysis showed that only 43 percent took them correctly the most recent time they had sex.

Over a median of nine months, 16 men became infected with HIV, including two who were assigned to the actual medication. Those two men appeared to not have followed directions: One returned 60 of 60 pills at a visit, while the other returned 58 of 60; researchers couldn’t find signs of the drug in their bodies when they were diagnosed with HIV. The researchers calculated that taking the medication reduced the risk of infection by 86 percent. Those taking the drug did report more side effects than those who took the placebo, such as gastrointestinal adverse events (14 versus 5 percent; P = 0.002) and renal adverse events (18 versus 10 percent; P = 0.03).

“Our study provides an alternative choice for gay men. They can use PrEP either daily or on demand,” lead author Jean-Michel Molina, M.D., Ph.D., a professor of infectious diseases at the University of Paris Diderot, told HealthDay.

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