On-Demand PrEP Effective Among MSM, but High Rates of STIs Observed

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Taking pre-exposure prophylaxis (PrEP) "on demand," meaning only around the time of sexual intercourse was effective in preventing HIV infection among men who have sex with men (MSM), Jean-Michel Molina, M.D., of the University of Paris Diderot reported at AIDS 2016. Molina presented the final results from an open-label extension of the IPERGAY trial, which had been stopped early because the study regimen overwhelmingly prevented the acquisition of HIV.
The original IPERGAY trial reduced the likelihood of becoming infected with HIV by 86%. Its placebo arm was discontinued early to allow those participants also to benefit from the study findings. However, the high efficacy shown may have been due to initially high adherence rates, Molina cautioned. The shorter duration of the original study also meant that no long-term safety data on the intermittent use of tenofovir disproxil fumarate/emtricitabine (Truvada, TDF/FTC) for PrEP could be gathered.
An open-label extension in which everyone would receive the study drug had been planned before the initial trial was discontinued. The study team was therefore able implement that extension within eight days of stopping the IPERGAY trial. Same as the PrEP arm of the initial study, extension participants took two tablets of TDF/FTC two to 24 hours before having sex and one tablet both 24 and 48 hours after the initial dose. During ongoing sexual activity, participants took one tablet per day and the two final tablets after their last sexual intercours