A San Francisco Business Times article reports “eye-popping statistic” from a Kaiser Permanente study of approximately 500 individuals taking Truvada once a day as pre-exposure prophylaxis to prevent HIV.
The study, which enrolled a majority of men who have sex with multiple men and was conducted through Kaiser’s HIV care and prevention program in San Francisco, confirms fears about the widespread deployment of PrEP as a public health prevention strategy. Condom-less sex leaves individuals unprotected from exposure to nearly all other STDs including syphilis, gonorrhea, chlamydia and HPV.
LOS ANGELES (December 8, 2014) A Kaiser Permanente study on the use of pre-exposure prophylaxis (PrEP) by gay men and men who have sex with multiple men to prevent possible HIV transmission has reported an “eye-popping statistic”—a 45% increase in condom-less sex among certain study participants.
The Kaiser study was first reported on in a news article by reporter Ron Leuty of the San Francisco Business Times, “S.F. men shed condoms in favor of Gilead’s HIV prevention pill,” published earlier today. The study, conducted through Kaiser’s HIV care and prevention program in San Francisco. enrolled approximately 500 individuals, a majority of whom were men who have sex with multiple men.
“This Kaiser study confirms the fears of organizations like AHF that have expressed caution and skepticism about the wisdom of the community’s wholesale embrace—as well as the CDC’s recommendation—of the widespread scale up of PrEP as a potentially prudent public health prevention strategy,” said Michael Weinstein, President of AIDS Healthcare Foundation. “Beyond the crucially important issue of medication adherence for those on PrEP, this study exposes another risk—and element of the CDC’s shortsightedness—as condom-less sex leaves individuals completely unprotected from exposure to nearly all other STDs including syphilis, gonorrhea, chlamydia, HPV and others. This study should serve as a warning and may one day be seen as the canary in the coal mine of unintended—but predictable—consequences of a poorly thought out public health strategy.”
To be clear, PrEP is not a medication taken in isolation. In fact, as part of its Boxed Warning for use of Gilead Sciences’ AIDS treatmentTruvada for a PrEP indication, the Food and Drug Administration (FDA) advises continued use of strategies including the use of “…safer sex practices such as consistent and correct use of condoms…” to reduce an uninfected individual’s exposure to HIV infection.
In mid-November, AHF published an advocacy ad in the form of an “Open Letter to the CDC: What if You’re Wrong About PrEP?”. The ad ran in The Hill, a daily newspaper serving and reporting on elected officials and government staffers in Washington DC, as well as in newspapers and magazines in seven markets or cities nationwide: New York, Los Angeles, San Francisco, Oakland, Dallas, Washington, DC and South Florida.
In May, the CDC recommended that 500,000 men-who-have-sex-with-men and other high-risk individuals go on PrEP, despite the fact that data from nearly all major PrEP studies do not support such large-scale public deployment of PrEP due to medication adherence issues: Even in carefully monitored clinical trials demonstrating the drug’s clinical efficacy, many study participants simply did NOT take the medication every day as prescribed.