Effective prevention tool not reaching those who could benefit from it, say researchers.
Vancouver, BC [March 3, 2016] A study from the BC Centre for Excellence in HIV/AIDS (BC-CfE), published in AIDS and Behavior, has found fewer than 30% of gay, bisexual and other men who have sex with men (MSM) in Vancouver are aware of pre-exposure prophylaxis (PrEP) for HIV, a proven-effective prevention method. Among MSM surveyed who were aware of PrEP, only one-third had discussed it with friends or sex partners in the last six months.
“PrEP can be a tool for stopping the spread of HIV, alongside the scaling up treatment for those living with the disease under Treatment as Prevention¨,” said Director of the BC-CfE Dr. Julio Montaner.”We have seen progress in reducing HIV viral load among Vancouver MSM, however there are remaining steps to close awareness gaps around HIV prevention. These include updating messaging to reflect options available, increasing access to PrEP and integrating it as part of a more comprehensive public health approach.”
BC-CfE’s survey of MSM, as part of its Momentum Study based in the Greater Vancouver area and using respondent-driven sampling, found only 20.9% of HIV-negative participants and 26.5% of HIV-positive men were aware of PrEP. At enrolment in the study (between February 2012 and February 2014), none had used or were using PrEP. In Canada, as of 2011, MSM account for approximately half of estimated new HIV infections and about one third of all new AIDS cases.
A daily dose of tenofovir disoproxil fumarate (TDF) and or/combination tenofovir-emtricitabine (TDF-FTC) can be used as HIV PrEP. In February 2016, Health Canada approved Truvada (a drug form of TDF-FTC) for this use; however, the drug’s high cost could potentially be a remaining barrier to access. Previous studies based in the United States have found relatively low levels of PrEP awareness and use, despite TDF-FTC having been approved for use as PrEP since 2012.
The only Canadian province to include coverage for Truvada for PrEP in their provincial health plan is Quebec, where uptake rates are higher.
“Awareness of PrEP remains low and, at this time, only people with private insurance plans have been able to access the drug-which can cost almost one thousand dollars per month,” said BC-CfE Researcher Dr. Mark Hull, an author of the study.”This unfortunately means very few individuals who could benefit from PrEP are being reached. Sexual health education and prevention options should be expanded to use the resources available now to end AIDS in the near future.”
The BC-CfE study found factors associated with PrEP awareness varied by HIV status and included greater optimism around HIV treatment with antiretroviral therapy among HIV-negative MSM. HIV-negative/unknown status MSM were more likely to be aware of PrEP if they were older, a student and had ten or more anal sex partners over their lifetime.
Regardless of HIV status, PrEP awareness was associated with participants who reported a prevention strategy of only having condomless anal sex with HIV-positive partners on treatment or with low viral loads. The research indicates PrEP-aware study participants may be part of a social/sexual network where higher sexual literacy has translated into increases in personal risk reduction.
The Momentum Health Study is a BC-CfE sexual health study of gay, bisexual and other men who have sex with men in Greater Vancouver. Momentum aims to report new estimates of HIV prevalence among men who have sex with men (MSM) in the region. The study is supported by grants from the U.S. National Institutes of Health and the Canadian Institute for Health Research.
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. The BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.
For additional information or to request interviews, please contact:
Caroline Dobuzinskis, BC-CfE
Cell: 604-366-6540
Phone: 604-682-2344 ext. 66536
Email: cdobuzin@bccfe.ca
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