2018 HIV Drug Therapy October 2018

A report on Sheena McCormack's presentation "PrEP: What's happening in Europe and the world in general"

This presentation outlined the current status of PrEP uptake around the world. It touched on some of the challenges and outlined some of the anticipated new medications and new modes of delivery of PrEP.

The overwhelming message is that PrEP using TDF/FTC either daily or on demand is effective in averting new HIV infections ( PREVENIR study 85 HIV infections averted; EPIC N.S.W. 31.5% decline in recent infections compared with previous year, 25% reduction attributed to  PrEP; Soho London clinic 80% decline in HIV cases since 2015).

A report on Jean-Michel Molina's presentation "STIs among MSM: New challenges in prevention, diagnosis and treatment"

The success of Antiretroviral therapy (ART) in the treatment and prevention of HIV has resulted in a marked reduction in the perception of risk of HIV, AIDS and death, termed “risk compensation”, and has resulted in reduced condom use. From 2013 to 2017 community level change in consistent condom use with casual partners fell from 46% to 31%. Over the same period, STI rates in 12 months increased from 17% to 31%.  This was accompanied by increased HIV, and presumably other STI testing. Of note, over the same period both those with HIV being treated with ART increased to 94% and with those with an undetectable viral load also increased to 94% (Holt M. et al Lancet HIV 2018).