American Academy of HIV Medicine study in its April ‘15 HIV Specialist magazine reports 95% of medical providers surveyed were concerned about adherence when deciding whether or not to prescribe PrEP.
At the same time, news that only 5,272 prescriptions for pre-exposure prophylaxis (PrEP) have been written between 2012 and 2014 comes via a paper presented by UCLA’s Dr. Raphael J. Landovitz at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) in February of this year in Seattle.
LOS ANGELES (June 10, 2015) A study published in the April 2015 issue of ‘HIV Specialist’ magazine, the official magazine of the respected American Academy of HIV Medicine (AAHIVM), reports that 95% of medical providers surveyed were concerned about adherence when deciding whether or not to prescribe PrEP to their patients. PrEP (pre-exposure prophylaxis) is the use of Gilead Sciences’ effective HIV/AIDS medication Truvada to prevent HIV transmission in uninfected individuals.
According to the survey (April 2015 HIV Specialist Magazine, p#20), published by AAHIVM, the following issues most concerned HIV/AIDS medical providers. “When measured by the proportion of providers who selected the factor as ‘Very Important,’ concerns about adherence (95%), regular follow-up care for monitoring and counseling (93%), and the effectiveness of PrEP in preventing HIV (82%) emerged as the top three considerations in providers’ decision to prescribe PrEP across all four regions.” The survey, which included 53 questions, was sent via Survey Monkey to 3,484 HIV/AIDS physicians and providers and includes responses from 324 individuals.
Shortly before, a paper presented in February by Raphael J. Landovitz, MD, MSc, Associate Professor of Medicine at the UCLA Center for Clinical AIDS Research and Education, at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) reported that only 5,272 prescriptions for pre-exposure prophylaxis or PrEP have been written between 2012 and 2014 (CROI presentation: slide #68, beginning at 24:56)—a two and one-half year period. These data, based on reports from Gilead, represent reporting from approximately 39% of retail pharmacies nationwide and <20% of Medicaid data.
“There appears to be a real disconnect between the hype around PrEP and the reality of what doctors—and patients—actually seem to be doing with regard to PrEP,” said Michael Weinstein, AIDS Healthcare Foundation president. “95% of HIV/AIDS medical providers expressed concern about adherence when deciding whether to prescribe PrEP to their patients, while at the same time, it appears that only 5,272 formal prescriptions have been written for PrEP through the end of 2014. Doctors appear to be rightly cautious and the public has not been clamoring for PrEP as a prevention tool in ways that match the rhetoric surrounding the issue. Every clinical study that demonstrates the pharmacological efficacy of PrEP also has shown adherence—the key to PrEP’s real world efficacy—to be a problem. Like it or not, adherence is part of the science, and that science still does not justify widespread deployment of PrEP as a public health intervention, such as the CDC’s suggestion that 500,000 high-risk Americans go on it. We believe PrEP should remain a prevention tool used on a case-by-case basis decided upon by a provider working in conjunction with his or her patient.”