Can new ‘Smart PrEP Pills’ increase adherence for HIV-prevention medication among young people?

From the Daily Herald online…

How does the smart PrEP work?

“The pill Truvada — the only PrEP drug approved by the Food and Drug Administration — has a sensor tablet encapsulated over it, so that when the pill is swallowed, the sensor tablet comes in contact with gastric fluid in the stomach and creates an electrical signal,” explained Dr. Gregory Huhn, CCHHS’ Associate Professor of Infectious Diseases and principal investigator of the trial. “The electrical signal is less than the frequency of a heartbeat, so nobody is going to feel it. But it transmits a signal in real-time that the pill has been ingested.”

By having a record of when the pill has been taken that goes to both the patient and his or her doctors or providers, the providers can reach out to patients who haven’t been taking the pills as directed and find out if there are any issues they can help resolve-like medication side effects a patient might be having or that they’ve run out of medication, Brothers said.

PrEP is supposed to be taken once a day.

Read the full article.

HIV pre-exposure prophylaxis can be taken as needed

From Reuters Health

Men at risk for HIV infection can safely take pre-exposure prophylaxis (PrEP) when they need it, instead of every day, suggests a new study.

In a study of gay and bisexual men, researchers found that taking four doses of PrEP around the time of sexual activity cut the risk of being diagnosed with HIV by 97 percent.

The pill, marketed by Gilead as Truvada, contains a combination of the two anti-HIV drugs emtricitabine and tenofovir disoproxil fumarate. Truvada was approved by the U.S. Food and Drug Administration for PrEP in 2012. Typically, the pill is taken daily.

The participants and the dosing schedule used in the new study were drawn from the IPERGAY clinical trial, which was discontinued early in 2014 after the drug was found to be highly effective at protecting against HIV.

“There are consistent data suggesting that on-demand PrEP before and after sex strictly following the IPERGAY dosing schedule . . . is also highly effective and could be an alternative to daily PrEP,” said Dr. Jean-Michel Molina, lead author of the new study and principal investigator of the trial.

The 361 men in the new study were enrolled from France and Canada after the completion of the IPERGAY trial. They were told to take two doses of Truvada between two and 24 hours before sex, another dose 24 hours later and a fourth dose 24 hours after that.

One participant who stopped taking PrEP during the roughly 18 months of follow-up was diagnosed with HIV, researchers reported July 23 in The Lancet HIV to coincide with presentation at the 2017 International AIDS Society Conference in Paris.

The overall rate of HIV among those in the study was 0.19 cases per 100 people per year. That compared to 6.60 cases per 100 people per year among men who were assigned to take a dummy pill during the larger trial.

The researchers found that about 14 percent of study participants reported minor stomach issues that eventually cleared up. Only four men stopped using the medication.

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Undetectable viral load “completely effective” at stopping HIV transmission, study finds

From Buzzfeed

A groundbreaking new study found zero transmissions occurred between HIV-positive men with an “undetectable viral load” due to treatment, and their HIV-negative partners, across thousands of instances of anal sex without a condom.

The Opposites Attract study, led by professor Andrew Grulich from the Kirby Institute, followed a cohort of 358 gay male couples – one partner HIV-positive, the other HIV-negative – in Australia, Thailand and Brazil.

The HIV-positive partners in the study had an “undetectable viral load”, meaning they are on treatment to suppress the virus so it is undetectable in the blood.

Not a single HIV transmission occurred across the almost 17,000 times participants reported having anal sex without a condom.

12,000 of those sexual encounters were protected solely by the HIV-positive partner’s undetectable viral load, and in the other 5,000, the HIV-negative partner was also taking a drug to protect against contracting HIV, known as PrEP.

“It really does confirm that undetectable viral load is completely effective at preventing transmissions in gay couples,” Grulich told BuzzFeed News from Paris, where he is presenting the research to the International Aids Society (IAS) Conference on HIV Science.

“Essentially, we’re documenting that this is a form of safe sex for couples in this situation.”

Read the full article.

Video series tackles bareback reality of HIV prevention

From South Florida Gay News

One film student is showing a “fun, sexy and outrageously frank 21st-century sex-ed for gay adults.”

“PrEP is an HIV prevention strategy that deals with sex, namely bareback sex,” film student Chris Tipton-King told Queerty. “And I got tired of people tip-toeing around that fact.”

PrEP stands for pre-exposure prophylaxis and reduces the risk of getting HIV from sex by more than 90 percent. Truvada is the drug prescribed for the treatment.

Tipton-King wasn’t happy with depictions of PrEP, which he felt was too sanitized and “awkward.” So as one of his assignments for his master’s degree in cinema, he created “The PrEP Project.” It’s a four-part video series that shows a more realistic side to gay men, their sex lives and the use of PrEP. Each video is 5-minutes long.

Read the full article and watch the videos on South Florida Gay News.

The new gay sexual revolution

From Advocate.com

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV. The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Read the full article on Advocate.com.

New HIV testing, treatment and prevention clinic opens in Washington

From the Observer Reporter in Washington County…

An HIV/AIDS medical clinic is operating in Washington, focusing not only on assisting people who are HIV positive, but testing for the virus and preventing those at high risk from contracting it.

Central Outreach Wellness Center South opened three months ago at 95 Leonard Ave., Washington. It is in Suite 203 in an office building adjacent to Washington Hospital, but it is not affiliated with the facility. For now, the center is open Wednesdays and Thursdays, or by appointment. Walk-ins are accepted.

Initial screenings for and treatment of sexually transmitted diseases is conducted at the clinic, and is covered by the state Department of Health. Central Outreach is filling a need in the Washington area, which did not have an STD clinic since one closed more than a year ago.

Nurse practitioner Carol Priest of Arden is running the office. She is assisted by Braden Bash, who has been trained as a physician assistant and is waiting to take his boards.

Nurse practitioner Carol Priest and physician assistant trainee Braden Bash oversee operations at Central Outreach Wellness Center South

“We hope to be open Monday through Friday by summer,” Priest said.

Stacy Lane, a physician and Washington & Jefferson College graduate, opened the clinic by appointment only in December. It is a “satellite” of the Central Outreach Wellness Center she launched two years ago – and still operates – on Pittsburgh’s North Shore, near the Andy Warhol Museum. She said there was an urgent need for the Washington facility.

“We noticed there were more than 50 people driving from West Virginia to the North Shore, and that wasn’t counting Washington and Canonsburg folks,” Lane said.

“There were no STD options in that area. There was a huge deficit.”

That deficit was underscored by the drug crisis that engulfed the region in recent times. “HIV can be transmitted by drug use,” Priest said.

A major weapon being used to combat HIV, Priest said, is a pill called PrEP, which stands for pre-exposure prophylaxis and has the brand name Truvada. It was used as a treatment for HIV, but is now used as a preventative for people who have been diagnosed as HIV negative and others who are at high risk of getting the virus. “These are people who use (intravenous) drugs and share needles, gay men not using condoms,” Lane said.

PrEP, according to results, has been a huge success.

“Of 200,000 people who were HIV negative and are on that pill, there have been only three cases of HIV,” Lane said.

Lane specializes in infectious diseases and was motivated to do so years ago. An uncle died from AIDS while she was in high school and pondering a medical career.

Read the full article.

New online tool finds providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US

PrEP Locator is a national directory of providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US. PrEP Locator seeks to provide patients access to a national, integrated service including both public and private practice providers. An open source tool, PrEP Locator data and map-based widget are easily accessible via API.

logoThe Locator seeks to serve as a common repository for information regarding providers and clinics that prescribe PrEP. The Locator is an open source tool for those who are managing existing directories to share their resources in a common format, so that patients can access a national, integrated PrEP provider location service that includes both public and private practice PrEP providers. Data will be made accessible with open source tools to facilitate patient access through existing organizational websites and mobile apps.

PrEP Locator is presented by Emory University, in partnership with M•A•C AIDS Fund. The project is led by Dr. Aaron Siegler, Research Assistant Professor of Epidemiology at Emory University’s Rollins School of Public Health. The project is guided by a coalition of partners with expertise in the field of HIV prevention: PleasePrEPMe.org, Greater Than AIDS represented by the Kaiser Family Foundation, National Alliance of State & Territorial AIDS Directors (NASTAD).