Implementing pre-exposure prophylaxis could prevent most new HIV infections in transsexual women and men who have sex with men

Abstract

Background: Pre-exposure prophylaxis (PrEP) consists of administering antiretroviral drugs to HIV-seronegative individuals who engage in high-risk practices, with the aim of reducing the probability of acquiring the infection. Despite its safety and efficacy, PrEP is still not available within Spain's public healthcare system. The aim of this study was to estimate the preventive impact of adding PrEP to the other preventive measures. We estimated the number of HIV seroconversions that could have been prevented (if PrEP had been available) among initially seronegative transsexual women and men who have sex with men.

Methods: We conducted a descriptive study of recent HIV seroconverters between 2014-2016 in a reference HIV/sexually transmitted infection clinic in Madrid. We analysed the individuals who were indicated PrEP, according to the guidelines of the 2016 AIDS Study Group. The statistical analysis to estimate the HIV infections that could have been prevented (if PrEP had been available) was conducted using Stata 14.

Results: We estimated that 195 of the 228 men who have sex with men and transsexual women, with documented HIV seroconversion, were indicated for PrEP. Considering the preventive efficacy reported in European studies, we estimated that 168 HIV seroconversions could have been prevented, which represents 73.7% of the diagnosed infections.

Conclusions: The results confirm the need to promote combined preventive programs against HIV that integrate all possible measures, including PrEP.

Keywords: HIV; Hombres que tienen sexo con hombres; Men who have sex with men; Mujeres transgénero; Pre-exposure prophylaxis; Prevención; Prevention; Profilaxis preexposición; Transsexual women; VIH.