HIV pre-exposure prophylaxis (PrEP) has completely rewritten the rule book when it comes to the prevention of human immunodeficiency virus infections. When taken correctly, PrEP is approximately 99 per cent effective, clinical trials suggest. Because of its excellent effectiveness, the medication gives at-risk individuals better opportunities to protect themselves.

The theoretical benefits and clinical characteristics of PrEP are easily understood but for the first time, a large-scale real-world study has been used to shed more light on its actual effectiveness. The results drive home the message about the importance of making PrEP readily available and further increasing awareness about it.

Real World Data Confirms PrEP Theory

BBC presented the results of a very extensive real-world PrEP study in December 2023.

The study followed 24,000 people across England who have been on HIV PrEP at the time the clinical trial commenced. A total of 157 sexual health clinics agreed to participate, providing invaluable information about their patients and health outcomes linked to PrEP administration.

According to the UK Health Security Agency (UKHSA), one of the entities that led the PrEP Impact Trial, this is the largest real-world study of its kind to ever be conducted. Results were tracked for a period of almost three years – from October 2017 to July 2020.

As per the study results, the administration of HIV PrEP reduced the risk of an HIV infection by approximately 86 per cent.  Obviously, these results are different from the 99 per cent effectiveness that has been established through clinical trials. Such a difference is to be expected, however.

The gap between the clinical trials and the real-world study stems from inconsistencies pertaining to using a daily medication. Many people have issues adhering to such a medical regimen, be it because of forgetfulness, occupation or other social factors.

While the difference in the percentages is significant enough to warrant an additional discussion, the real-world trial establishes the high levels of PrEP effectiveness. For the first time since the approval of PrEP, research has demonstrated its incredible protective potential on a very large scale.

More Work to Be Done for Better Outcomes

The study has come out at a time when we’ve seen discouraging news about PrEP, especially about its availability among marginalised groups.

Studies published earlier during the year suggest that stigma linked to being on PrEP is preventing individuals who’d benefit from it from seeking the medication. Furthermore, the stigma is often diminishing effectiveness because it’s keeping people from taking their daily pill.

Better awareness and education about the importance of HIV PrEP and HIV post-exposure prophylaxis (PEP) are both needed to normalise such medical interventions and make it easier for people to seek such protective options.

The authors of the latest real-world analysis also confirm the importance of awareness and de-stigmatisation, especially among members of minority groups.

According to the authors, there are currently groups of people and communities that could benefit significantly from PrEP but aren’t accessing the medication because of social factors, personal or cultural beliefs.

The report also suggests that some demographic groups aren’t even aware of the existence of PrEP. In the UK, for example, it’s a prophylactic option that many women aren’t familiar with.

Another important step would be to increase the availability of PrEP. In the UK and in various other parts of the world, it can currently be accessed through a visit to a licensed sexual health clinic. Making PrEP available in pharmacies and even online could be other great steps that will encourage more people to get this type of protection and enjoy its important benefits.

Making People Stay on PrEP and Guaranteeing Consistent Results

The final very important trend that the study has revealed is the inability of some people to stick to their PrEP regimen for whatever reason.

The authors have thus recommended interventions aimed at encouraging people who are on PrEP to stay on it and to take their daily pill.

Based on result analysis, health authorities will also get to make better recommendations about the kind of PrEP that is bound to deliver the best results for a certain group of individuals.

Most people who are looking for HIV prevention are given oral PrEP – a pill that has to be taken daily in order to guarantee the protective results.

Alternatives like injectable PrEP, however, are also existent. Injectable PrEP is a long-acting form of the medication. People who are on it will need to visit a sexual health clinic every few weeks in order to get their next dose. For certain demographics, injectable PrEP improves adherence and delivers better results than daily oral PrEP.

Know Your Options, Look for Better Protection

HIV PrEP and PEP are both readily available in Singapore through licensed medical facilities like Shim Clinic.

If you believe you may be at risk, do stop by and get yourself tested for HIV and other common sexually transmitted diseases (STDs). At Shim Clinic, you’ll benefit from a tailored approach and a fully confidential consultation that will acquaint you with the options.

Come to Shim Clinic during working hours every day of the week or contact us now to have all of your questions about HIV PrEP and PEP answered.