A daily pill can effectively protect gay men against infection with HIV, a UK trial has shown, which experts say now offers hope of reversing the virus’s spread. Taking the drug, called Truvada, could become a daily routine for men who have sex with men in the same way that the contraceptive pill is for women, some believe. NHS England will now study the results to determine whether it is cost effective to provide it for men at risk of infection.
The study, carried out in 12 NHS trusts, showed that Truvada, which is already used to treat people with HIV, cut infections among men who have sex with men by 86%. Experts are delighted by the success rate because the study was carried out in “real world” situations, with participants free to use the pills or not as they chose. Fears that men would not take the pills regularly proved to be unfounded.
The study, Proud (Pre-exposure Option for reducing HIV in the UK: immediate or Deferred), follows a number of trials in other countries and has achieved a success rate higher than all of them. Launched in 2012, it recruited 545 men who have sex with men who were considered to be at high risk of HIV infection through sexual health clinics. Those who were recruited had a median of 10 partners in the previous 90 days.
Half the group were randomly allocated to get Truvada immediately, while the other half were given it after a year. Among the men who started the drug straight away, there were three HIV infections, but among the other group who did not have the drug, there were 19. The results were presented at the Conference on Retroviruses and Opportunistic Infections in Seattle, US, and will be published later.
“These results are extremely exciting and show PrEP [pre-exposure prophylaxis] is highly effective at preventing HIV infection in the real world,” said Sheena McCormack, professor of clinical epidemiology at the MRC Clinical Trials Unit at University College London, and chief investigator of the study.