A Lack of Pep for PrEP

By Emily Largent

The Kaiser Family Foundation (KFF) recently conducted a survey of gay and bisexual men in the U.S. focusing on attitudes, knowledge, and experiences with HIV/AIDS.  The survey results, released Thursday, can be found here.  I was most interested in the finding that only a quarter of those surveyed know about PrEP (pre-exposure prophylaxis).

PrEP (brand name Truvada) is a combination of two medicines (tenofovir and emtricitabine) that has, if taken consistently, been shown to reduce the risk of HIV infection in people who are high risk by up to 92%.  The FDA approved an indication for the use of Truvada “in combination with safer sex practices for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 in adults at high risk” in 2012.  The U.S. Public Health Service released the first comprehensive clinical practice guidelines in May of this year.

It’s been said that PrEP has the potential to change the course of HIV in the U.S.  Yet, only 26% of the gay and bisexual men surveyed by KFF know about PrEP; 31% believe no such medication exists, and 43% say they don’t know.  This, despite the fact that an estimated 12-13% of gay and bisexual men in the U.S. are living with HIV (more than 20 times the rate among the general population), and from 2008 to 2010, HIV incidence increased among men who have sex with men (12% increase) while remaining stable or declining among injection drug users and heterosexuals of all races.

In October 2013, I. Glenn Cohen asked, in a post on this blog: Why no one is on the first treatment to prevent HIV?  It appears from the KFF survey that one part of the answer is that people just don’t know.
Emily Largent

Emily Largent

Emily Largent is an Assistant Professor of Medical Ethics and Health Policy at the Perelman School of Medicine. She also teaches at the University of Pennsylvania LawSchool. Her research examines ethical and regulatory issues arising in human subjects research and when integration of clinical research is integrated with clinical care; she has a particular focus on Alzheimer’s disease research. Emily received her PhD in Health Policy (Ethics) from Harvard and her JD from Harvard Law School. Prior to that, she received her BS in Nursing from the University of Pennsylvania School of Nursing and completed a fellowship in the Department of Bioethics at the National Institutes of Health.

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