PrEP Pre-Exposure Prophylaxis Lori Miller AVAC: Global Advocacy for HIV Prevention 22 MAY 2010

What is PrEP? Experimental HIV prevention strategy that would use antiretrovirals (ARVs) to reduce the risk of HIV infection in HIV-negative people In this strategy, people would take a single drug, or a combination of drugs, before exposure to HIV, with the hope that it would lower their risk of infection PrEP is still experimental and has not yet been shown to work in humans

tenofovir disoproxil fumarate -TDF Brand name: Viread PrEP Agents in Effectiveness Trials Oral PrEP tenofovir disoproxil fumarate -TDF Brand name: Viread tenofovir plus emtricitabine – TDF/FTC Brand name: Truvada Topical PrEP tenofovir gel

Current Ideas on How PrEP Could be Used Oral: daily Oral: intermittently Topical: gel Topical: vaginal ring, other formulations Injection, long-term acting methods

Concerns about PrEP Long-term drug for healthy people: different risk benefit ratio Potential for side effects and toxicity over time Potential for resistance: current agents being studied are used for HIV treatment Adherence for healthy people HIV testing would be required for PrEP access and on an ongoing basis With limited resources for HIV treatment, is it appropriate to use ARVs for prevention? Delivery in resource limited settings

The PrEP Pipeline Oral: largely based on tenofovir Topical: robust pipeline with many compounds being considered Injectable: TMC 278LA

Thank you!