ANRS launches first PrEP trial for gay men in Europe

via iPrEx NEws

The ANRS (French National Agency for Research on AIDS and Viral Hepatitis) is about to launch in Europe the first pre-HIV exposure prevention trial in men who have sex with men.

This phase III trial—ANRS IPERGAY—will start at the end of January 2012, in Paris (Hôpital Saint-Louis, Professor Jean-Michel Molina and Hôpital Tenon, Professor Gilles Pialoux) and Lyon (Hôpital de la Croix-Rousse, Dr Laurent Cotte), and later in Montreal in Quebec (CHUM Hôpital Hôtel Dieu, Dr Cécile Tremblay). The trial will include 300 volunteers in the pilot phase and ultimately 1900 in total.

ANRS IPERGAY will involve men who have sex with men and seronegative trans men who have anal sex with men without routine use of condoms, with at least two different sexual partners in the six months prior to trial participation. Participation will last for between 12 (minimum) and 48 (maximum) months.

The trial will compare two groups of participants, one given Truvada®, the other a placebo, taken in both cases during the period of sexual activity, starting before sexual relations and ending afterwards.

All participants, irrespective of group, will be offered various means of prevention: free condoms, regular HIV screening, regular screening for and treatment of sexually transmitted diseases, vaccination against hepatitis A and B. Participants can ask for personalized prevention advice, if they wish.

An important part of the trial will involve a social sciences study of the profiles of participants and analysis of their sexual behavior, in particular regarding condom use, and will determine whether or not they take the medication as intended.

Participants will be invited to the hospital every two months or so for an interview and for clinical examinations, including screening tests.
The ANRS will sponsor and fund the trial, and Gilead will supply the medication.

The HIV community-based association Aides helped draw up the protocol, is a scientific and operations partner in the trial, and is a member of the scientific board. It will coordinate recruitment in the field and provide volunteers with prevention support.

ANRS press contact:
Marie-Christine Simon – Tel : +33 (0) 1 53 94 60 30 marie-christine.simon@anrs.fr



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Do men who have sex with men use serosorting with casual partners in France?

Do men who have sex with men use serosorting with casual partners in France? Results of a nationwide survey 

Abstract:

We examined whether men who have sex with men (MSM) in France have adopted serosorting with their casual partners, serosorting being one strategy to reduce the risk of HIV transmission. We expected to see the same predictors of this practice with casual partners in France as in other similar MSM communities (HIV-seropositive, Internet dating). Data from a cross-sectional survey was used, based on a self-administered questionnaire conducted among readers of the gay press and users of gay websites in 2004. The study population consisted of MSM who reported their HIV status, as well as the practice of unprotected anal intercourse (UAI) with a casual partner at least once during the previous 12 months. Among 881 respondents included in the analysis, 195 (22%) had practiced serosorting: 14% among HIV-seropositive men and 26% among HIV-seronegative men. Serosorting was independently associated with the use of cruising venues (AOR 0.28, p=0.001) and Internet dating (AOR 2.16, p=0.051) among HIV-seropositive men, whereas it was independently associated with the use of cruising venues (AOR 0.59, p=0.013) and the fact of having less partners (AOR 1.50, p=0.046) among HIV-seronegative men. Serosorting requires an up-to-date knowledge of HIV serostatus for MSM and their UAI casual partners, and does not prevent from acquiring other sexually transmitted infections. Prevention campaigns are needed to underline the risks associated with serosorting.

Read the entire article.

Treatment as prevention rejected by French ministry of health

via Aidsmap, by Roger Pebody

The endorsement of treatment as prevention by the French National AIDS Council has been dismissed by the country’s ministry of health.

In April, the National AIDS Council (Conseil National du Sida) issued a lengthy and nuanced analysis of the potential impact of greater use of antiretroviral treatment on HIV transmission and prevention. It recommended campaigns to raise awareness of the benefits of HIV testing and earlier treatment, and that negative messages about side-effects and pill burden should receive less emphasis.

The National AIDS Council is independent body of experts (academics, clinicians, politicians etc.) who are nominated by various parts of the government. It has a consultative role.

However a press statement issued by the Direction générale de la santé (the section of the health ministry responsible for public health) rejected the National AIDS Council’s analysis.

The statement insisted that only male or female condom use could guarantee a maximum protection against HIV and other sexually transmitted infections, and that condoms must be used consistently during casual sex or when the HIV status of a stable partner was not known. The statement said there was no conclusive evidence concerning men who have sex with men, the efficacy of antiretroviral treatment as a sole prevention strategy or the risks of resistance if more people took treatment.

The ministry announced that a new group of experts would be asked to reconsider treatment as prevention as part of their review of HIV prevention strategies. The opinions of this group are likely to feed into France’s next three-year HIV strategy.

The campaigning group The Warning denounced the conservatism of the Direction générale de la santé. They said that the health ministry “remains silent” about the residual infection risk associated with condom use, and did not address the issue of the growing number of people who don't use a condom, either some or all of the time. “They show that they still believe it is possible to put into place a prevention strategy that takes no notice of the choices and behaviours of individuals,” the group commented.