SEATTLE, WA — What if, in couples among whom one partner is infected with HIV, and the other is not, the protective benefits of antiretroviral drugs could be used to maximum advantage? That would mean, eventually that the infected partner would enjoy the full benefits of treatment, including a sufficient suppression of virus to lower risks of transmission to almost none. In the meantime, the uninfected partner could take an antiretroviral drug preventively — as PrEP, or pre-exposure prophylaxis — as a bridge to treatment. That was the thinking behind a “Demonstration Project of PrEP and ART,” in Kenya and Uganda, presented by Jared Baeton of the University of Washington today, at a session on prevention this morning. In a session dominated by discussion of the success of PrEP in two trials among men who have sex with men in Europe and Canada, and the reasons for the failure of a microbicide gel to protect women from HIV in South Africa this presentation highlighted the success of a tailored approach in Africa. The result, as the title of the talk told it, was “the near elimination of HIV transmission.”
The couples recruited were considered at high risk for transmitting/acquiring the virus, with an effort to enroll younger couples with no children, high levels of virus in the infected partner, uncircumcised men, and who had sex without condoms. More than 1,000 couples were enrolled, and 85 percent stayed in the study. Pregnancies occurred in 20 percent of the couples each year. During the course of the study, which began in 2012 and ended in August 2014, two participants, both women, became infected.