Pre-exposure prophylaxis against HIV (PrEP) based on the oral administration of prevention antiretroviral drugs (tenofovir DF / emtricitabine) which, although authorized in the European Union since 2016, its use is not yet regulated in Spain. In 2017, the Ministry of Health, Consumption and Social Welfare launched, in collaboration with some Autonomous Communities, a study to evaluate the feasibility and reliability of the implementation of PrEP. The results of the first 24 weeks of this study reveal that no case of HIV infection has been recorded.
The investigation was launched in November 2017 in Barcelona and San Sebastián, and 8 months later it was joined by Valencia. The study has about 400 participants (gay men, bisexuals, other men who have sex with men and trans women) distributed in different points of these cities: STI Center in coordination with the Hospital of Donostia, BCN Checkpoint (a community center in coordination with the Germans Trias i Pujol Hospital in Badalona), ITS Drassanes Unit (in coordination with the Vall d’Hebron Hospital) and the General Hospital of Valencia.
The results show that no HIV infection was recorded in those first 24 weeks of the study. One of the people registered was diagnosed at the baseline visit, which makes the screening of HIV and other STIs even more important, before starting the study. In the same way, the degree of adherence reported was very high and constant: 93.7% at week 4 and 94.4% at week 24. In parallel, an increase in gonorrhea rates was observed (8.6% at start and 10.4% at week 24) and syphilis (baseline levels of 3.3%, compared with 5.6% at week 24), but a decrease in chlamydia rates (from 7.1% at 5.9%). However, these changes were not statistically significant.
Among other significant data, there was also a decrease in condom use among users compared to the initial visit. Thus, 5.2% said never to use them compared to almost two thirds (65.4%) who declared using them regularly or practically always. At week 24, only 37.9% said they used them regularly or always and a little more than a quarter (25.8%) said never to use them. On the other hand, one of the most unexpected results of this study was the decrease in the consumption of substances and also in the polydrug use, a significant fact against the popular “Chemsex“. The reason behind this finding is not very clear, although in the subsequent debate he pointed out that it could be due to a lower degree of anguish due to the HIV of the participants, thanks to the protection offered by PrEP.
In the same session of the congress, the BCN PrEP-Point results were presented, in which several studies on PrEP are being carried out, as well as the follow-up of people who take PrEP informally. In the congress, data from 862 people in PrEP attended were presented: 493 through participation in 3 studies and 369 people who take PrEP informally. Taken in their sets the data of all these people supposes a total of 783 people to the year of and the analysis shows that the use of the PrEP achieved a descent of 76,5% in the number of infections by the HIV since they took place only 4 cases of infection against the 17 cases that would have been expected in that number of people during that period of time.