Thursday, August 19, 2010

HIV, transmitted drug resistance, and the paradox of preexposure prophylaxis

Proceedings of the National Academy of Sciences of the United States of America
by Virginie Supervie, J. Gerardo García-Lermb, Walid Heneine, and Sally Blower

If the results from the phase III trials ending in 2010 show moderate to high efficacy, then PrEP interventions could be implemented in the near future in resource-rich countries. We have shown PrEP could significantly reduce transmission in the MSM community in San Francisco even if efficacy is only moderate, provided coverage is high and risk compensation does not occur. High coverage may be attainable: recent surveys indicate ~70% of MSM in California and in Massachusetts have stated they would be willing to take PrEP on a daily basis if it were proven safe and effective (41, 42); furthermore, MSM reporting risky behaviors were more likely to anticipate using PrEP (42). Although our quantitative results are specific to the MSM community in San Francisco, the qualitative insights we have gained are applicable to any high-risk community where treatment has been readily available for many years and current levels of transmitted resistance are already high.
Read the entire article.

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