A study which gave Truvada as pre-exposure prophlaxis (PrEP) to people in Uganda and Kenya found the drug cut the HIV rate by three quarters.
The findings from the SEARCH study were presented virtually at the International AIDS Conference by the University of California’s Catherine A. Koss, MD.
The study involved HIV-negative men and women in 16 rural communities in western Kenya and southwestern and eastern Uganda. Truvada was offered to people with an HIV-positive partner who were either considered at high risk of contracting HIV or who said they felt they were at a high risk.
25 people tested positive for HIV over 7,150 cumulative follow-up years, making up an infection rate of 0.35 infections per 100 cumulative follow-up years. A matched control group which was not given Truvada saw an expected infection rate of 0.92 infections, meaning Truvada was linked to a 74 percent reduction in infection rate. This reduction was statistically significant.
Truvada was offered, with the option to start it on the same day, at clinics and health fairs during blanket HIV testing campaigns between 2016 and 2017. The drug was also offered to at-risk populations with high HIV rates such as bar workers, transportation workers and fishers. The drug was offered in every rural community in the study from 2016 to 2019.
Follow-up visits were offered at community sites like trading centers or beaches, the homes of patients and clinics. Those who received the drug were given HIV antibody testing before being given Truvada, at weeks 4 and 12 and every week thereafter until week 144.
74,541 people 15 years old or older were tested and were given negative test results. 58,909 of those people were found to not be at elevated risk for HIV, leaving 15,632 at an elevated risk. 5,447 people in that group started taking Truvada and 4,260 of those had at least one HIV test after beginning PrEP.
49% of those who started on Truvada were women or adolescent girls. 16 percent were 45 years old or older and 29 percent were 15 to 24 years old. 19 percent said their partner was HIV-positive. 22 percent worked in the industries of transport, bar or fishing. 51 percent were in a monogamous marriage, 19 percent were in a polygamous marriage and 21 percent were unmarried. 49 percent of the men were circumcised. Circumcision reduces female-to-male HIV transmission by around 60 percent.
Truvada has been linked to decreased bone density, osteoporosis, kidney damage and renal failure when it is used to treat existing HIV infections, but not when it is used as PrEP.