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Wednesday, February 20, 2013

Aidsmap---PrEP wars: debating pre-exposure prophylaxis in the gay community

via Aidsmap, by Gus Cairns

Last World AIDS Day, 1 December 2012, Online Buddies (OLB) Inc. (the company behind, one of the most popular gay online dating sites in the US, and its affiliated health education site Manhunt Cares) sent out a bulk email to its members informing them of its World AIDS Day campaign to increase awareness of pre-exposure prophylaxis – PrEP.

PrEP means HIV-negative people taking antiretroviral (ARV) drugs to stop them from acquiring HIV infection. A series of trials two years ago, including the iPrEx study in gay men, showed that PrEP could prevent more than 90% of HIV infections in people who took it consistently, but also that a lot of people in the trials didn’t take it enough, or at all.

The US Food and Drug Administration (FDA) approved tenofovir plus emtricitabine (Truvada), the two-drug pill used in the trials, for use as PrEP, in July last year.

The European Medicines Agency (EMA) is still considering approval. Throughout Europe, centrally funded health systems are likely to demand more rigorous guidelines on targeting and budgeting before authorising PrEP.

In practice, uptake rates in the US have been low and not many HIV-negative men are aware of this new HIV prevention option. In conjunction with Fenway Health, the LGBT sexual health centre in Boston, and the Harvard School of Medicine, Online Buddies researched Manhunt’s users and found that even after the iPrEX study results1 were announced, only one in five of its users were at all aware of PrEP and only 1% had ever used it, though when given a description of it, nearly 80% said they potentially might.2

For those depressed by ongoing high HIV incidence rates amongst gay men and impressed by the PrEP trial results, a campaign to alert the community to the possibility of this new HIV prevention method was needed.

“One of our guiding principles is to fill critical gaps in health promotion campaigns,” says David S Novak, Online Buddies’ senior health strategist. “Normally, we spotlight a variety of different issues, but this year PrEP was the obvious thing.”

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