Spreading the word about HIV prevention
My name is John Byrne, and I am the Managing Director of Prevention Access Campaign. I am contacting you on behalf of both Human Rights Campaign and the Prevention Access Campaign (PAC), a health equity initiative focused on ending the dual epidemics of HIV and HIV-related stigma. As you may know, HRC is America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender, and queer people.
We enjoyed reading your article “Spreading the word about HIV prevention for African American women” published on March 2 and appreciate your work to educate people about the current realities of HIV. That said; we did want bring a potential error/inconsistency to your attention.
You write “If the daily pill is taken consistently, it can reduce the risk of HIV infection by up to 92 percent.” While factually accurate, this reflects a lower efficacy rate than has been demonstrated in peer-reviewed scientific studies.
Current science and mathematical modeling has consistently demonstrated PrEP to be 99% effective at preventing HIV if taken as prescribed. In studies which showed individuals contracting HIV while taking PrEP, those individuals who seroconverted were later discovered to have not been taking the drug more than four times per week.
Scientific modeling shows PrEP’s effectiveness to be 76% at two doses per week, 96% fewer than four doses per week and 99% for four or more doses per week. (http://stm.sciencemag.org/content/4/151/151ra125). A fuller explanation of PrEP failures is available at Dr. Robert Grant’s blog:https://www.robertmgrant.org/project/has-prep-ever-failed/ (Dr. Robert Grant conducted the iPrEX study under which PrEP was approved by the FDA.)
While this is seemingly a minor issue, patients considering PrEP frequently consult the Internet for research when electing whether or not to take it. For this reason, we’ve partnered with HRC to make sure information about PrEP’s efficacy is current. Confusion about efficacy usually centers on the fact that while there were seroconversions in several of the studies, these were not individuals who were taking PrEP as prescribed.
HRC has partnered with PAC to ensure public communications about HIV reflect the latest science and the best thinking we have available. Are you willing to update your article in light of this information? We would be more than happy to hop on the phone with you to discuss in more detail if needed.
If you have any questions or concerns, please do not hesitate to email me.
Thank you, John Byrne Managing Director Prevention Access Campaign