[HARMRED] PREP

[Daniel Raymond]

Hi Monte --

There's a major PrEP study among drug injectors that's been going on in
Thailand for several years, and is expected to release results next year.
The other major PrEP studies that have released data over the last year have
all looked at sexual transmission, so we don't have any information yet on
whether PrEP is effective at reducing transmission through shared injection
equipment.

One dilemma is that there's good reason to believe in the United States that
among people who inject drugs, especially in areas that have some level of
syringe access, HIV transmission is just as likely to occur through sex as
through shared needles. So for IDUs with dual risks, there may be a decent
rationale to look at PrEP to lower their sexual risk of HIV, even if we
don't know whether it will reduce their injection-related risk.

The other consideration is that we don't necessarily need PrEP to
substantially reduce or eliminate injection-related HIV transmission,
because we know that syringe access (along with testing, access to
methadone/buprenorphine, etc.) are very effective (where available).  Even
if the Thailand PrEP study shows that PrEP is effective for preventing HIV
among IDUs, we don't know how well that translates to the U.S. epidemic, or
if there are subsets of IDUs in the U.S. (e.g., men who have sex with men &
inject drugs) where PrEP is more useful.

Daniel

Daniel Raymond
Policy Director
Harm Reduction Coalition
22 W. 27th Street, 5th Floor
New York, NY 10001
(212) 213-6376 x29
Fax: (212) 213-6582
raymond at harmreduction.org
www.harmreduction.org



On Wed, Oct 12, 2011 at 10:49 PM, Monte Levine <montelevine at gmail.com>wrote:

> There was a posting recently on a Seattle list serve regarding a PREP study
> that would use gay men and transgendered people to run a trial of
> pre-exposure prophylaxis. Does anyone know of clinical trials for prep that
> include people who inject?
>
> Just curious
>
> monte levine
>
>
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