AHF: NIH Finally Waking up to Drawbacks of PrEP

CNBC article reports, “The National Institutes of Health (NIH) announced last week that it was entering the first-ever global clinical trial of an injectable HIV-prevention drug called cabotegravir.”

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH, said: “The ultimate reason for the trial is that many people who take Truvada have difficulty with having to take a pill every single day … That really becomes prohibitive, and sometimes people don’t adhere really well.”

LOS ANGELES (January 6, 2017) In response to recent news reports that the National Institutes of Health (NIH) is participating in the first-ever trials of an injectable, longer-acting form of pre-exposure prophylaxis (PrEP) to prevent HIV transmission—in these trials, utilizing ViiV Healthcare’s drug, cabotegravir—advocates from AHF expressed guarded optimism at the potential for this new method of HIV prevention, which does not rely on strict daily adherence to an oral pill regimen, such as with current PrEP regimens using Truvada.

Instead, the new trials will examine whether one single injection or shot of ViiV’s medication can provide a preventive benefit from HIV acquisition for up to eight weeks versus a daily pill regimen of Truvada. Part of the NIH’s reasoning for participating in the study of this potentially longer-acting form of PrEP is a recognition of some shortcomings of current PrEP regimen protocols—including heavy or absolute reliance on patient adherence to the current daily medication regimen requirements.

“At long last, the NIH is finally waking up to drawbacks of PrEP as we know and currently deploy it,” said Michael Weinstein, president of AIDS Healthcare Foundation.

In one news report on NIH’s participation in this latest HIV prevention protocol study, CNBC quoted Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH (as told to NBC Out):

“The ultimate reason for the trial is that many people who take Truvada have difficulty with having to take a pill every single day,” Fauci said. “That really becomes prohibitive, and sometimes people don’t adhere really well.”

“We have said since the beginning of this debate that an injectable or timed-release form of a medication to prevent HIV acquisition would be a superior option than relying so heavily on patient adherence to a daily pill regimen,” added Weinstein. “Since the roll out of PrEP, there have been isolated reports of HIV transmission—mainly due to interruption in adherence to the medication—as well as skyrocketing rates of STDs, particularly among young people, even though FDA guidelines for PrEP include continued condom use. We look forward to monitoring the progress of these latest NIH studies and reiterate our concerns questioning the wisdom of widespread deployment of the current PrEP protocol as pragmatic public health intervention.”