Using Pre-Exposure Prophylaxis (PrEP) as a Prevention Tool for MSM: The Promise Comes with Challenges

via Blog.AIDS.gov, by Dr. Ron Valdiserri

Excerpts:

On Saturday, February 26^th, I attended a day-long meeting organized by the Centers for Disease Control and Prevention (CDC) and hosted by the Fenway Community Health Center in Boston. The theme of the meeting was “Moving forward with PrEP Implementation.” Meeting participants included researchers involved in the original iPrEX study and other ongoing HIV prevention studies, health care providers caring for men-who-have-sex-with-men (MSM), state and local health department program directors, MSM community advocates, policy experts, and federal officials...

Several of the major questions raised by participants were:

• Among the diverse communities of MSM in the U.S., what subset of men would be the most appropriate candidates for this new prevention tool?
• Given the disproportionate burden of HIV infection among MSM of color—many of whom also live at or near the poverty level—how will daily drug treatments be financed?
• In the real world of competing needs and resource constraints, how should PrEP programs for MSM be combined with other prevention approaches for MSM to result in the greatest pay-off in terms of decreasing new HIV infections?
• How do we build the needed capacity among medical providers, health departments, and community-based organizations so that PrEP can be implemented as part of a comprehensive package of HIV prevention services for MSM at risk for HIV?
• Could PrEP serve as a “gateway” into other equally effective—and perhaps less costly—prevention approaches for MSM?

Read the rest.