FOR IMMEDIATE RELEASE
December 20, 2010

 
Contact: Chris Viveiros
617.927.6342 / 617.721.7494
cviveiros@fenwayhealth.org
  

THE FENWAY INSTITUTE RELEASES PRELIMINARY GUIDANCE FOR PROVIDERS ON USE OF PRE-EXPOSURE PROPHYLAXIS FOR HIV PREVENTION

The Fenway Institute has issued preliminary guidance for medical providers on the use of pre-exposure prophylaxis (PrEP) as an HIV prevention tool.  This guidance follows publication of a November 23, 2010 New England Journal of Medicine article on the results of the iPrex trial showing that PrEP reduced HIV infection in gay and bisexual and other men who have sex with men (MSM) and transgender women. 

Those taking the medication daily had a 44 percent lower rate of HIV infection than those in the placebo.  When looking at only those with a high adherence level who reported at taking at least 90% of their medication, the protective effect exceeded 70 percent.  For those in whom medication was detected in their blood, risk of infection decreased by more than 90 percent.  The Fenway Institute was one of two American sites involved in this study and Dr. Kenneth Mayer, Medical Research Director and Co-Chair of The Fenway Institute is one of the study authors.  More about the iPrex study and results at www.fenwayhealth.org/iprex.

As this is the first published study on this novel approach to HIV prevention, it is likely that clinicians will be approached by patients requesting PrEP for HIV prevention. The Fenway Institute is offering interim guidance for prescribing and supporting patients seeking PrEP in advance of development of guidelines by government agencies or professional societies.

Recommendations for providers considering starting a patient on a PrEP regimen include:

• HIV counseling and testing should be conducted per CDC guidelines prior to initiating PrEP.
• There should be discussion and counseling regarding alcohol and drug use.
• Patients should undergo a screening for sexually transmitted infections (STIs).
• Patients receiving PrEP should undergo adherence counseling as the protective effect is greater with higher levels of adherence.
• PrEP prescriptions should be provided in conjunction with other HIV prevention messages and approaches: counseling and testing, risk reduction counseling, condom education and distribution and STI counseling, testing and management.
• Providers should review potential drug interactions and side effects.

The full guidelines are available at www.fenwayhealth.org/prepguidance.

“PrEP offers a new tool that we can use to prevent HIV infection.  Our goal in issuing this guidance is to help providers make informed decisions about how best to work with their patients who might benefit from PrEP,” said Dr. Harvey Makadon, Director of Professional Education and Development at The Fenway Institute.  “At the same time, we want to make sure that we continue to focus on other HIV prevention approaches that have proven effective: condom use, knowing your status and discussing it with your partners, getting regular HIV and STI testing and HIV risk-reduction counseling.  PrEP is intended as a tool to supplement those approaches, not replace them.”

For nearly forty years, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBT community, people living with HIV/AIDS and the broader population.  The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues.  Fenway’s Sidney Borum Jr. Health Center is dedicated to providing the best quality health care for youth and young adults ages 12 to 29 who may not feel comfortable going anywhere else.  More about all of our programs and services can be found at www.fenwayhealth.org.