The test roll-out of PrEP in Australia has led to a dramatic reduction in HIV infections among gay and bisexual men.
Researchers found that new infections in this group in New South Wales (NSW) declined by almost one-third following the introduction of the HIV prevention medication in March 2016.
The globally unprecedented reductions provide strong evidence to support the large-scale, targeted provision of PrEP to prevent HIV transmission. The results of the EPIC-NSW trial were published in The Lancet HIV.
When taken daily, PrEP prevents HIV negative people from acquiring the virus. The trial is the first study globally to measure the impact of PrEP on reducing HIV in a large population.
“The speed of the decline we’ve seen in new HIV infections in gay and bisexual men is a world first,” said Professor Andrew Grulich from the Kirby Institute at UNSW Sydney, who led the trial. “In the year following the trial, state-wide new HIV infections in this population decreased by one third. These numbers are the lowest on record since HIV surveillance began in 1985,” explained Grulich.
“Our research tells us that these reductions are a result of PrEP, implemented on a background of high and increasing HIV testing and treatment rates.”
The declines were highest among Australian-born gay and bisexual men (48.7%) and gay and bisexual men living in the ‘gay suburbs’ of Sydney (51.8%).
“These communities had the highest uptake of PrEP, and in these populations, new HIV infections have halved since the trial began,” said Grulich. “However, we did not see the same reductions across the board. Reductions were lower in non-English speaking immigrants with a smaller 21% decline among those born in Asia. We need to improve education and promote access to PrEP, particularly amongst culturally and linguistically diverse men who have sex with men, and those outside the gay neighbourhoods of Sydney.”
NSW was the first state in Australia to trial PrEP at a large scale. “The results from EPIC-NSW provide an important evidence-base to inform our response to HIV globally,” noted Grulich. “We now know that PrEP implemented quickly, at a large scale, and targeted to high-risk populations can help turn the HIV epidemic around.”
It is estimated that there more than 150,000 people on PrEP around the world. PrEP is available for free for gay, bi and other men who have sex with men in limited locations in South Africa. It can also be bought through a doctor’s script.