Great double session by John De Wit who discussed the current state of play with the VICPrEP study.
In summary - PrEP works! There have been a number of RCTs showing decreased HIV acquisition with PrEP. Of course, adherence is paramount to success.
One of the concerns put forward is that PrEP use may decrease condom use; risk compensation.
VIC PrEP, thus far, has been a demonstration project. They have undertaken a multI-site , open label study. Participants have taken Truvada daily for 12 months.The 92 participants with follow up data took regular surveys to examine attitudes and behaviours regarding PrEP.
They looked at the amount of regular & casual partners, frequency of sex as well as risk reduction methods - Serosorting, VL sorting, positioning, withdrawal and condom use. Interestingly , there was no change in sexual behaviour with regular partners while the main significant change in behaviour with casual partners was some decrease in condom use. What does this mean? well, Yet to be determined as adherence to PrEP was generally very good.
However, it's most important that PrEP is part of comprehensive package - with STI screening, condom use promotion.
Look forward to further data from this study!