PrEP Update: The Facts Speak for Themselves, Notes AHF

Statistics exposing the low uptake on PrEP regarding how few people really are on PrEP were presented by Gilead at the American Society for Microbiology Conference in June. In response, AHF rolls out a new national ad campaign challenging the hype versus reality on pre-exposure prophylaxis for HIV prevention.

AHF’s ‘Open Letter to the CDC on PrEP’ ad campaign starts this week in seven US markets or cities nationwide: New York, Los Angeles, San Francisco, Atlanta, Dallas, Washington, DC and South Florida.

LOS ANGELES--(BUSINESS WIRE)--Beginning this week, AIDS Healthcare Foundation (AHF) will roll out a new national ad campaign in the US in the form of an “Open Letter to the CDC on PrEP.” The ad challenges the hype versus reality surrounding PrEP, the use of Gilead’s HIV/AIDS treatment medication Truvada for pre-exposure prophylaxis as an HIV prevention tool.

The catalyst for AHF’s “Open Letter” advocacy ad is the apparent lack of interest in, and low uptake of PrEP by both patients and medical providers, according to damning statistics provided directly from Gilead that it presented at the American Society for Microbiology (ASM) Conference in June of this year. In a research presentation titled, “Racial Characteristics of FTC/TDF for Pre-exposure Prophylaxis (PrEP) Users in the US,” Gilead reported that just over 49,000 total cumulative prescriptions for Truvada as PrEP have been filled in the US since the FDA first approved use of Truvada as PrEP four years ago. (49,148 total cumulative prescriptions based on data reported by 82% of all pharmacies from January 1, 2012 through September 30, 2015.)

AHF created the advocacy ad to raise awareness about effective HIV and STD prevention strategies, particularly in light of simultaneous skyrocketing rates of STDs reported by the CDC (and for which PrEP offers no preventive protection or benefit) among young people, gay men and men who have sex with men (MSM) that suggest a widespread abandonment of the culture of condom use. A Guardian news article published July 5^th cited similar Public Health England (PHE) research showing a dramatic and parallel increase in STDs in the same populations in England between 2012 and 2015.

AHF’s ad, written in the form of an open letter to the CDC, first appeared Wednesday, July 20^th in the South Florida Gay News (SFGN) and will start running today (7/21) and tomorrow (7/22) in six other markets nationwide over the next week.

“Regarding the hype versus the reality on PrEP, we have Gilead to thank for letting the facts speak for themselves, thanks to its comprehensive research presented in Boston last month on actual PrEP usage and uptake,” said Michael Weinstein, President of AHF. “Gilead’s own research shows that despite the tremendous hype, uptake of PrEP has been abysmally low and that it is not reaching those most at risk. The concurrent explosion of STDs among populations targeted for PrEP suggests an abandonment of the culture of condoms. Taken together, these are not good indicators of prudent and effective public health strategies for HIV and STD prevention. We need to recalibrate and rebalance prevention efforts to align with what patients want and need so that we can all achieve better success in preventing new infections.”

Under the headline ‘An Open Letter to the CDC on PrEP,’ AHF’s ad reads:

Four years ago on July 16, 2012, the Food and Drug Administration approved use of Truvada for the prevention of HIV, which is also known as Pre-Exposure Prophylaxis (PrEP)¹. In a report released by Gilead Sciences on June 20, 2016, they revealed the following information:

1. 49,148 total cumulative prescriptions for Truvada as PrEP have been filled based on data reported by 82% of all pharmacies. While it is unknown how many people who were originally prescribed the drug are still on it, based on adherence information in previous studies, no more than half the people actually took the drug on any type of consistent basis². Therefore, we estimate that about 25,000 are still taking Truvada for prevention. Of these patients 79% were men or about 20,000.

2. We are assuming almost all of these 20,000 are men who have sex with men (MSM). Studies estimate that there are 4,875,000 MSM³ —or 3.9% of the 125 million adult men in the US. As a result, we can conclude that less than .04% of MSM are taking Truvada for PrEP. CDC has suggested that 1.2 million men⁴ should be on PrEP but doctors and patients are not responding to that call in large numbers. PrEP cannot be a major factor in preventing HIV when so few people are on it. On the other hand recent studies indicate that 60% of MSM use condoms regularly⁵, based on last sex among HIV-negative MSM.

3. African-Americans are 12% of the US population but are 44% of new HIV infections⁶. However, they are only 10% of people on PrEP. Young people are most at risk for new HIV infections, but made up only 7.6% of PrEP prescriptions. Whites represent 27% of new infections but made up 74% of those on PrEP. The men who are taking PrEP are those least at risk from HIV.

4. PrEP does not protect people from STDs. The rapid rise in rates of STDs such as syphilis, chlamydia and gonorrhea⁷ indicate that fewer people are using condoms and suggesting the need to reinvigorate safer sex campaigns, which have suffered greatly as a result of the CDC's almost exclusive focus on PrEP.

5. The wide-scale advertising promotions of Truvada for PrEP by AIDS organizations and community groups funded by the manufacturer Gilead Sciences gives the impression that PrEP is very popular even though the raw numbers tell another story. Based on the large number of men who say they are on PrEP on hook-up sites such as Grindr, it would appear that they are seeking unprotected sex whether they take the drug or not.

The CDC is the national agency responsible for the prevention of HIV and other STDs. As such, we call on you to rebalance your prevention efforts to align with what patients want and need so that we can achieve better success in preventing new infections.

Thank you.

AIDS Healthcare Foundation

___________________

¹ Food and Drug Administration. (2012). FDA approves first drug for reducing the risk of sexually acquired HIV infection. Retrieved online: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm

² Cohen SE et al. (2014). Implementation of PrEP in STD Clinics: High Uptake and Drug Detection Among MSM in the Demonstration Project. 21st Conference on Retroviruses and Opportunistic Infections (CROI). Retrieved online: http://www.croiconference.org/sessions/implementation-prep-std-clinics-high-uptake-and-drug-detection-among-msm-demo-project

³ Jones JM. (22 June 2016). Same-Sex Marriages Up One Year After Supreme Court Verdict. Gallup. Retrieved online: http://www.gallup.com/poll/193055/sex-marriages-one-year-supreme-court-verdict.aspx

⁴ Centers for Disease Control and Prevention. (24 November 2015). Transcript for CDC Telebriefing: Daily Pill Prevents HIV – New CDC estimates underscore the need to increase awareness of a daily pill that can prevent HIV infection. Retrieved online: http://www.cdc.gov/media/releases/2015/t1124-hivprep.html

⁵ Paz-Bailey G et al. (2016). Trends in condom use among men who have sex with men in the United States: The role of antiretroviral therapy and sero-adaptive strategies. AIDS.

⁶ Centers for Disease Control and Prevention. (November 2015). Diagnoses of HIV Infection in the United States and Dependent Areas, 2014. Retrieved online: http://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf

⁷ Centers for Disease Control and Prevention. (17 November 2015). Reported Cases of Sexually Transmitted Diseases on the Rise, Some at Alarming Rate. Retrieved online: http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html

AHF’s “Open Letter to the CDC on PrEP” ad will run in newspapers and magazines in seven (7) markets or cities nationwide and hit the streets this week: South Florida (‘South Florida Gay News’ issue date: 7/20/16 and ‘Florida Agenda,’ 7/21/16); New York (‘Gay City News,’ issue date: 7/21/16); Los Angeles (‘Frontiers Newsmagazine,’ issue date: 7/22/16); San Francisco (‘Bay Area Reporter,’ issue date: 7/22/16); Dallas (‘Dallas Voice,’ issue date: 7/21/16); Atlanta (‘GA Voice’ online issue date: 7/22/16) and Washington, DC (‘The Washington Blade’ issue date: 7/22/16 and ‘Metro Weekly,’ issue date: 7/22/16).

Gilead’s Supplemental New Drug application (SNDa) to the FDA for use of its AIDS treatment Truvada for HIV prevention was approved four years ago on July 16, 2012. In May 2014, shortly before the International AIDS Conference in Melbourne, Australia, the CDC issued a public recommendation that 500,000 high-risk individuals in the United States go on PrEP. On November 24, 2015, the CDC revised its recommendation upward, suggesting that 1.2 million people—including one in four gay men— go on PrEP.

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 666,000 individuals in 36 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare.