New Study Confirms Effectiveness of PrEP in HIV Prevention

PrEP is a pill that contains two drugs, tenofovir and emtricitabine, that can block HIV from infecting the cells of the immune system. PrEP has been shown to be very effective in preventing HIV infection in randomized clinical trials, with up to 92 percent efficacy in people who have detectable levels of the drugs in their blood. However, there are few observational studies that have confirmed the effectiveness of PrEP when it is prescribed in real-life situations, where people may have different profiles, behaviors, and adherence patterns.

A new study, published in The Lancet Public Health1, aimed to assess the real-world effectiveness of PrEP in men at high risk of HIV infection in France. The study used data from the French national health data system, and compared the HIV status of men who were prescribed PrEP with those who were not, between 2016 and 2020. The study matched each person who was diagnosed with HIV with up to five controls who were not, based on their age, socioeconomic status, place of residence, calendar year, and follow-up duration. The study also characterized the PrEP use of each person based on the amount and frequency of the drug dispensing over time.

The study found that PrEP was effective in reducing the risk of HIV infection by 60 percent overall, reaching 93 percent for a high amount of PrEP consumption, and 86 percent if excluding periods after PrEP discontinuation. The study also found that PrEP effectiveness was significantly lower in people younger than 30 years and in those who were socioeconomically deprived, both of whom had low PrEP consumption and high PrEP discontinuation rates. The study concluded that PrEP effectiveness is lower in real-world conditions than in clinical trials, and that efforts to improve PrEP compliance and monitoring are essential, especially among young and disadvantaged recipients.