Unrealistic Expectations Might Reduce PrEP Acceptability

Published: June 3, 2011

A new study suggests there might be a very high bar for acceptance of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM), transgender females and female sex workers. The study, published in the May 5 issue of the International Journal of STD & AIDS, found that PrEP would need to be cheap, highly effective and used only intermittently before these groups would want to use it.

Ever since the news broke in late 2010 that a Truvada (tenofovir plus emtricitabine) PrEP regimen could reduce new HIV infections by 44 percent or more, experts and community members have been questioning how to safely roll out this new prevention intervention and whether people would even want to use it. Scientists and public health experts had assumed that PrEP—whereby HIV-negative people take antiretroviral (ARV) medication to prevent becoming infected—would likely work, but they remained uncertain how to use it if studies confirmed its efficacy.

Subsequently, researchers with the University of California in Los Angeles partnered with researchers at the Cayetano Heredia University School of Public Health in Lima, Peru, to begin answering this key question.

“Just a few months ago, we learned that PrEP can prevent HIV infection, but it has not been deployed on a large scale yet and is a topic of debate in the HIV-prevention research community,” said Jerome Galea, Latin America regional director for the UCLA Program in Global Health and one of the study’s co-investigators.

Galea and his colleagues turned to the same populations that were included in the original iPrEx PrEP study—mostly Peruvian MSM and female transgenders—plus female sex workers and presented them with a number of scenarios to determine what factors would influence their likelihood to use PrEP.

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