reach high concentrations in the blood, the side-effects from Tenofovir are much lower. Second, because the concentration of the drug is high in tissues, the protective effects from Tenofovir Alafenamide may be greater and last longer than compared to Tenofovir.
So in a very large study with over 5,000 gay men, randomly assigned to take either Truvada or Tenofovir Alafenamide/Emtricitabine (TAF/FTC) daily for PrEP, both combinations were extremely effective in preventing transmission of HIV. With tens of thousands of unprotected sex acts over a year, there were 15 cases of HIV infection in the Truvada arm but only 7 infections in the TAF/FTC arm.
These infection rates are much lower than we would observe if PrEP wasn’t being used. While the TAF/FTC arm appears to provide better protection, we cannot state that with absolute certainty, based on the statistical analysis. But there is certainly a strong suggestion the TAF/FTC may be better than Truvada. It is important to keep in mind that in the cases where the men got infected, they were not taking all of their PrEP doses properly.
Again, this reminds us that PrEP works to protect from HIV infection WHEN PEOPLE TAKE IT! It works for heterosexuals, gay men, intravenous drug users; every group that has been studied. Hopefully, this study can help TAF/FTC gain approval for use as PrEP.
Dr. Crawford has over 25 years of experience in the treatment of HIV. While at Howard University School of Medicine, he worked in two HIV-specialty clinics at Howard University Hospital. He then did clinical research as a visiting scientist with the AIDS Clinical Trials Group (ACTG) at Johns Hopkins University School of Medicine. He served as the Assistant Chief of Public Health Research with the Military HIV Research Program where he managed research studies under the President’s Emergency Plan for AID Relief (PEPFAR) in four African countries.
He is currently working in the Division of AIDS in the National Institutes of Health. He has published research in the leading infectious diseases journals and serves on the Editorial Board of the journal AIDS. Any views and perspectives in his articles on blackdoctor.org are not representative of any agency or organization but a reflection of his personal views.