New HIV prevention methods: a daily pill and male circumcision

An article from guardian.co.uk reports that the results of two studies in Botswana, Kenya and
Uganda show that the partners of people who are HIV-positive can protect
themselves from infection by taking one tablet each day.

The larger study, led in Kenya and Uganda by the University of Washington’s
International Clinical Research Center, involved 4,758
discordant couples (where one partner is HIV-positive and the other is not).

Those taking a single tablet of the AIDS drug tenofovir had
62 percent fewer infections than those who took a placebo pill, and those who took a pill combining tenofovir and

emtricitabine had 73 percent fewer infections.

The principal investigator in the study, Dr Connie Celum, is
quoted as saying that the study “demonstrates that antiretrovirals are a highly
potent and fundamental cornerstone for HIV prevention and should become an
integral part of global efforts for HIV prevention.”

A smaller study was conducted in Botswana by the United
States Centers for Disease Control.

It followed 1,200 HIV-negative heterosexual men and women who received either a once-daily
tenofovir-emtricitabine tablet or a placebo pill. The antiretroviral tablet
reduced the risk of acquiring HIV by roughly 63 percent overall.

So why was the study done?

AIDS experts have said that attempts to promote condom use
to protect against HIV in the hardest-hit parts of the world hit cultural
barriers and had limited success. This latest study shows that men or women who
know – or suspect – their partners are HIV-positive could protect themselves.

According to the Program for the Collaboration Against AIDS and Related Epidemics, the results “provide exciting and strong evidence” that
the daily pill can “prevent HIV infections in persons at risk of heterosexual
infection.”

In a trial done in late 2010, taking the antiretroviral PrEP
with Truvada was proven effective for men who have sex with men, which brings
us back to the second HIV-prevention method mentioned at the beginning of the
blog – circumcision.

The Joint United Nations Programme on HIV/AIDS announced that a
study in South Africa confirmed “scaling-up adult male circumcision works
to prevent HIV in men.”

During the study, free circumcision services were offered to
heterosexual men over 15 years of age. Between 2007 and 2010, approximately 20,000 circumcisions were
performed. Results showed a 55-percent reduction in HIV prevalence and a 76-percent

 

reduction in HIV incidence in circumcised men.

Community-based surveys revealed that there were no changes
in sexual behaviour during the study.

Michel Sidibé, the executive director of UNAIDS, had this to
say:

“Science is proving that we are at the tipping point of the
epidemic. Urgent action is now needed to close the gap between science and
implementation to reach the millions of people who are waiting for these
discoveries. Scaling-up voluntary medical male-circumcision services rapidly to
young men in high HIV-prevalence settings will help reach the 2015 goal of
reducing sexual transmission of HIV by 50 percent.”

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