PrEP should be made available to all HIV-negative individuals on demand Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health Attending.

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Presentation transcript:

PrEP should be made available to all HIV-negative individuals on demand Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health Attending Physician Ronald Reagan Medical Center Division of Infectious Diseases: Global Health David Geffen School of Medicine Department of Epidemiology Karin and Jonathan Fielding School of Public Health IUSTI 2016 Marrakesh

Disclosures Dr. Klausner is a faculty member of the University of California Los Angeles Dr. Klausner is a guest researcher with the US CDC Mycotics Diseases Branch Dr. Klausner is a member of the WHO STD Treatment Guidelines workgroup Dr. Klausner is a board member of YTH (non-profit) Dr. Klausner is unpaid medical advisor for Healthvana In the past 12 months, Dr. Klausner and/or UCLA Regents has received: – Research funding, donated supplies or unrestricted gifts from the NIH, CDC, Hologic, Gilead Sciences, Cepheid, Standard Diagnostics, Alere, MedMira, bioLytical, AIDS Healthcare Foundation and Sentient Research – Advisory fees from Flora Biosciences, Roche, Black AIDS Institute, Social Scientific Systems

5 Top Reasons to Give PrEP to Anyone PrEP works PrEP is safe People need it Ethically right Good for business

PrEP (Truvada) works Antonín Holý

I. Truvada is Effective PROUD (TDF/FTC ) CI: % 99% VOICE 99% (TDF)(TDF/FTC) -49%-4.4% CI: +3 to -129CI: +27 to -149 Partners PrEP (TDF/FTC) CI: 28-84CI: % CI: 20-83CI: (TDF) 71% 66% 84% TDF2 (TDF/FTC) CI: CI: %80% FEM-PrEP (TDF/FTC) CI: % iPrEx (TDF/FTC ) CI: % iPERGAY (TDF/FTC ) CI: % Slide courtesy of Raphael Landovitz, MD, UCLA, March 2015

II. Truvada is Safe Clinical – Mild short-term nausea +/- diarrhea (10%) – Decreased appetite + weight loss (5-10%) – Reversible small decrease in bone density (1%) – Reversible small decrease in kidney function (0.5%) Sexual health – Decrease in condom use – Increase in syphilis and rectal gonorrhea and chlamydia

PrEP compares favorably with aspirin regarding safety

III. People need it Non-disclosure of risk Kyle Bernstein et al, Archives of Medicine, 2008 HPTN 052 Blood donor studies

People lie

IV. Ethically right

Beneficience To do good Prevent disease where one can, prevention is preferable to cure Hippocrates

Humanism Prime importance to human rather than divine or supernatural matters Humanist beliefs stress the potential value and goodness of human beings, emphasize common human needs, and seek solely rational ways of solving human problems.

V. Good for business

Gilead needs it

Summary of Reasons to Give PrEP on Demand PrEP works PrEP is safe People need it Ethically right Good for business

Summary

Summary of Reasons to Give PrEP on Demand PrEP works PrEP is safe People need it Ethically right Good for business

Thank You