San Francisco will soon become the first city in the nation to offer pre-exposure prophylaxis (PrEP), the daily use of an antiretroviral drug therapy that has dramatically reduced new infections in HIV-negative gay and bisexual men.
Daily use of the cocktail—a combination of tenofovir and Truvada—has shown up to 73 percent efficacy in preventing HIV transmission. The demonstration project would launch in early 2012, reports the Bay Area Reporter.
Under the contract, up to 300 men who have sex with men at high risk for contracting HIV would be enrolled in the pilot study. City Clinic would administer the program while Magnet, the gay men's health center in the Castro, would help identify suitable participants for the study.
The exact funding amount for the National Institutes of Health Implementation Science Study is still being determined. And San Francisco is expected to partner with counterparts in Miami on the study to see if gay men want to use PrEP, and if so, how to safely administer the medical prevention technique.
Magnet Director Steve Gibson told the B.A.R. that, so far, few of the clinic's patients have asked about the HIV prevention tool or its availability. Those who have, he said, either took part in the iPrEx clinical trials, known locally as PREPARE, or are HIV-negative men who have HIV-positive partners. Some of the questions Gibson said he hopes the demo project will answer are not only how gay men adopt using PrEP but also how to ensure lower income gay and bi men and men of color have access to it.
Some critics of PrEP believe its availability will encourage more gay men to engage in risky sexual practices. Others are concerned about resilience and the impact of powerful antiretrovirals on a healthy immune system. But the major question is who will pay for the drug: In the United States, Truvada can cost $36 a day or up to $14,000 a year.
The news comes after the release of disturbing HIV seroconversion data. New HIV cases among Black gay and bisexual men aged 13-29 rose an estimated 48 percent between 2006-2009, according to the Centers for Disease Control and Prevention. In San Francisco, Black men account "for the highest incidence rates of HIV cases among men," BAR reported in May.
Some Background:
Preparing for PrEP
"Alarming Increase" in HIV Young Black Gay Men
Daily Drug Reduces HIV Transmission
HIV a Rite of Passage for Young Black Gay Men?
1 in 3 Black Gay Men HIV Positive; 60% Unaware
"Alarming" HIV Rates Young Blk Gay Men in Miss.
CDC: 42% Black Gay Men in Milwaukee are HIV+
HIV "Epidemic" Among Black Gay Chicago Men
CDC: Young Black Gays Hit Hardest by HIV Infections
What PrEP Could Mean for Black Gay Men
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