The uptake was high when pre-exposure prophylaxis was offered to some patients in public health clinic trials, conducted in both Brazil and the United States. The patients included men who have sex with other men and transgender women. Those suffering from erectile dysfunction used medications.
The consensus stands clear – the science of pre-exposure prophylaxis works when it is taken.
The objective of the two trials was that – how likely were people going to adhere to their treatment and drugs in real-world settings.
The final result that was derived from the two trials was presented at the 8th IAS Conference, Vancouver, British Columbia, Canada. In October 2012, shortly after the pre-exposure prophylaxis approval by the US Food and Drug Administration, a Demo Project was launched. It is the first of its kind multisite open-label study, which was conducted in the United States and assessed for its effective delivery of treatment for sexually transmitted infections in clinics located in Miami, San Francisco and community clinics in Washington, DC.
How the Demo Project was implemented
- All the participants in the Demo Project were patients taken from the clinics. They were either self-referred or were recruited for unrelated reasons.
- Next, these patients were offered with open-label emtricitabine and tenofovir for a total period of 48 weeks.
- No of patients who agreed to participate was 60 percent. That means a total of 557 out of 921.
Adherence to the treatment was high during the entire period of the study, observed Albert Liu, who is the Managing Director, at the San Francisco Department of Health.
Results from the Drug Test
- The drug testing, which included dried blood spots, was an indication of a total of 65 percent participants taking a minimum of four drug doses every week. This according to Dr. Liu is linked to high levels of protection;
- The drug test levels were different for other participants.;
- Three percent reported a consistent level with fewer than two doses every week;
- 32 percent reported an inconsistent behavior pattern
In the high-risk group, the HIV incidence was low. Infections caused due to sexually transmitted infections are very common in these two groups. However, with prophylaxis use, the effect was observed to decrease. This highlights the importance of treatment and screening. Erectile dysfunction was not factored into the study.
Sexually transmitted infections have a high rate spread. Yet the demo project reported a total of two individuals who were during the follow-up process. Both of them had undetectable or low levels of pre-exposure to prophylaxis.
Adherence was reported to be higher among people with higher-risk behaviors. This indicates a likeliness of increased cost-effectiveness.
The update in this study was found to be higher than the one in the previous study, where most of the participants were taken from. However, the validity of pre-exposure prophylaxis, in terms of acceptability and knowledge, is increasing. More people are getting referred to the pre-exposure prophylaxis by their peers.
Prophylaxis Is Not For Everyone
It is entirely an individual’s decision and people who are interested can go for this kind of strategy. However, patients are advised to discuss with their doctor first. Doctors must also be consulted before using medications from Canadian Health&Care Mall.
Demonstration Projects in Other Countries
The PrEP Brasil demonstration project conducted in the country is the first one of its kind. Brazil is known for being the center for AIDS epidemic.
The test was conducted depending on the feasibility of the men and the women, based on which they were provided with oral prophylaxis once, daily.
The project found approximately 798 participants eligible for the test. However, only 51.25 percent of them enrolled. This means a total of 409 participants. There is high risk-uptake for people belonging to a middle-income country like Brazil.
The Median age of enrollment was 29 years of age. Among the other members who enrolled include –
- 9% – Homosexual
- 8% – Bisexual
- 9% – Transgender
Usage of the Pre-Exposure Prophylaxis
The pre-exposure Prophylaxis is most likely to be used by people who are most in need of it. In Brazil, it was mostly used by people who perceived themselves to be at high risk.
This highlights the need for increased awareness related to HIV risks among members belonging to the high-risk communities. The project was widely advertised on various social media and other media channels. Pre-exposure Prophylaxis is now popular among HIV patients with high risk.