PrEPing while gay sexing drops HIV risk 86%

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A dose of pills before and after for gay men taking part in risky sex could dramatically lower their chance of HIV infection, another hint that the power of PrEP makes a difference.

The encouraging development – and nod of approval from federal health officials at the Centers for Disease Control & Prevention – came Tuesday during the 22nd Conference on Retroviruses & Opportunistic Infections in Seattle. Two new studies taken together show that pre-exposure prophylaxis (PrEP) works whether it's used daily or before and after sex for men who engage in risky sex frequently. 

Both studies – the IPERGAY trial from a French national HIV research agency and PROUD from the U.K. Medical Research Council – showed that PrEP reduced the risk of HIV infection among gay men by 86 percent.

Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD & TB prevention, cheered the results of both studies. 

“CDC welcomes the findings presented today by the IPERGAY and PROUD teams, which provide additional evidence of the power of PrEP to reduce the risk of HIV infection,” Mermin said in a prepared statement. 

Here's how the two studies worked:

IPERGAY studied 400 participants who took a novel approach to PrEP – instead of a daily pill, they took pills three days around the time of sex, including a two-pill dose between 2 and 24 hours before sex, two single-pill dosages 24 and 45 hours after sex and one pill daily if they continued to have sex during the initial pill regimen.

Therefore, the number of days PrEP was taken each week would vary depending on the frequency of sex, sometimes resulting in near daily use. In any week where sex occurred, there could be as few as four PrEP pills used (with a single act of sex) or as many as eight (with daily sex).

The PROUD study confirmed the results of other PrEP studies, showing that daily oral PrEP using Truvada substantially reduced the risk of HIV.

Mermin cautioned that the IPERGAY study does have its limitations. 

“It is not known whether the regimen will work if taken only a few hours or days before sex, without any buildup of the drug from prior use. Studies suggest that it may take days, depending on the type of sexual exposure, for the active drug in PrEP to build up to an optimal level for preventing HIV infection,” Mermin said.

With the IPERGAY study, frequent sex meant a median of 10 sex acts per month and eight partners every two months. 

HIV agencies are lining up behind PrEP as prevention, including AID Atlanta and Houston's Legacy Community Health Services. The CDC agrees. Heck, even Grindr wants you to enjoy your butt sex without worry. It's all a matter of deciding whether PrEP is right for you.

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