16 March 2018 Vol 359, Issue 6381
Concern as HIV prevention strategy languishes
By Jon Cohen
Science16 Mar 2018 : 1205 Restricted Access
Few countries promote prophylactic drug regimen, and many people shun it.
Some 200,000 people uninfected with HIV now take antiretroviral drugs as preventive medicine—but 75% of them are in the United States. Called pre-exposure prophylaxis, or PrEP, this daily pill has proved its worth in several clinical trials and was approved by the U.S. Food and Drug Administration in 2012. Other countries have been slow to adopt PrEP even though the World Health Organization recommended it for everyone at “substantial risk” of becoming infected. At the Conference on Retroviruses and Opportunistic Infections held in Boston last week, there was a growing clamor about the underuse of PrEP. In hard hit sub-Saharan Africa, only Kenya aggressively promotes the use of PrEP. Evidence from San Francisco, California, and the state of New South Wales in Australia, which both have prominent PrEP campaigns, shows that it has helped reduce new infection rates. Several presenters at the meeting discussed why PrEP has been slow to catch on both at the government level and with people who are at high risk of becoming infected. In 2016, nearly 2 million more people became infected with the AIDS virus, bringing the global total to 37 million.