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HIV prevention with PrEP: what it is, who it is aimed at, how much it costs

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HIV prevention with PrEP: what it is, who it is aimed at, how much it costs

The HIV prevention with PrEP. Now more and more people around the world are joining the pre-exposure prophylaxis – known as PrEP – which allows you to avoid contagion among people who are considered most at risk. The most exposed remain:

men who have sex with men (MSM), transgender and transsexual people, high-risk women and male and female sex workers, the so-called sex workers.

Even though almost forty years have passed, they are still There are many doubts about HIV and AIDS.

HIV prevention with PrEP: an English study promotes it with flying colours

A study commissioned by the British National Health Service confirmed that PrEP is able to reduce the chances of being infected or becoming infected with HIV by 99%.

The researchers analyzed data from 157 English clinical centers between October 2017 and July 2020. You can read the results in the scientific journal The Lancet HIV.

The research team confirmed that this research once again demonstrated the effectiveness of PrEP in preventing HIV transmission.

Given the results of this study, the researchers argue that it should now be sold in pharmacies and also online to increase the number of people who can use it. It is currently only available in hospital pharmacies. Even in Italy it is freeafter a long battle between associations dealing with sexually transmitted diseases.

HIV prevention with PrEP: how does it work?

Recruitment can take place in two different ways:

continuously, with one pill a day;
on demand, that is, as needed, with a pill taken because you are experiencing an episode at risk of HIV infection. Applies only to men and in Europe.

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Prevention of HIV with PrEP: -99% of cases of infection in a sexual context

“The Prevention through PrEP has an essential function. Despite great progress in HIV therapies with antiretroviral drugs and monoclonal antibodies, avoiding a multiplication of infections in the populations most at risk can constitute a significant barrier to the spread of the epidemic”.

“Pharmacological prophylaxis has demonstrated a high risk reduction. The Centers for Disease Control and Prevention in Atlanta confirmed a 99% reduction in sexual transmission and an 80% reduction in intravenous transmission among drug users. Its massive use would drastically reduce HIV infections, as demonstrated by the cases of San Francisco, London or Sydney. Furthermore, only 67% of the population affected by HIV has access to drugs, while 33% cannot be treated.” Silvia Nozza, infectious disease specialist at the San Raffaele Hospital in Milan.

New studies and new ways of hiring

“The new frontiers offer further potential. Recent studies in 2021 propose new formulations beyond the oral one currently on the market. The HPTN 084 study confirms the effectiveness of the long-acting drug cabotegravir administered intramuscularly. We are already in phase 3 and it has demonstrated solid foundations, not only for the MSM and transgender population, but also for women. It is the first study that has shown an efficacy of 89% also on the female population.” Elena Bruzzesi is a doctor in specialist training at the Vita e Salute San Raffaele University.

The Milan Check Point collected data from July 2017 to July 2021 to investigate the association between PrEP initiation and change in sexual behaviors among 534 participants. Most of them were residents of Lombardy, of which 96% were MSM. Three out of four were single, 67% graduated, 5.2% are sex workers and 16.7% practice chemsex, that is, having sex after taking chemical drugs. While taking PrEP, the average occasions of sex without a condom almost doubled, before settling at an intermediate level in the medium to long term. The number of casual partners has not changed significantly over time.

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HIV prevention with PrEP: still too little widespread in Italy

Unfortunately, PrEP still has some limitations in its diffusion in Italy. “The main problem in the effectiveness of PrEP is related to adherence to therapy. We can estimate around 25% of those who abandoned it after starting the path. Some cases are due to the end of the risk of exposure, such as when they get engaged and become monogamous. In many cases an economic problem also emerges, given that in Italy it is borne by people without any state support. This is unlike most European countries, where there is full reimbursement or a political price that makes it accessible even to the most vulnerable groups. Considering that HIV infection in Italy has a greater incidence between the ages of 25 and 29 or even in younger age groups, one can understand the greater difficulty in accessing a drug which costs around 60 euros per month”.

Beware of other sexually transmitted diseases. PrEp only prevents HIV

PrEP prevents HIV infections, but not other Sexually Transmitted Infections (STIs). If you remove other protections, the risk of contracting other infections increases. In fact, an increase of approximately 25% in STIs in people who use PrEP is estimated. However, it should be underlined that those who access prophylaxis undergo tests regularly every 3-4 months which the general population does not undergo.

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The article Prevention of HIV with PrEP: what it is, who it is aimed at, how much it costs comes from OK Salute e Benessere.

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