Pr EP PreExposure Prophylaxis Lori Miller AVAC Global

Pr. EP Pre-Exposure Prophylaxis Lori Miller AVAC: Global Advocacy for HIV Prevention 22 MAY 2010

What is Pr. EP? § Experimental HIV prevention strategy that would use antiretrovirals (ARVs) to reduce the risk of HIV infection in HIVnegative people § In this strategy, people would take a single drug, or a combination of drugs, before exposure to HIV, with the hope that it would lower their risk of infection § Pr. EP is still experimental and has not yet been shown to work in humans

Pr. EP Agents in Effectiveness Trials § Oral Pr. EP • tenofovir disoproxil fumarate -TDF Brand name: Viread • tenofovir plus emtricitabine – TDF/FTC Brand name: Truvada § Topical Pr. EP • tenofovir gel

Current Ideas on How Pr. EP Could be Used § § § Oral: daily Oral: intermittently Topical: gel Topical: vaginal ring, other formulations Injection, long-term acting methods

Concerns about Pr. EP § Long-term drug for healthy people: different risk benefit ratio § Potential for side effects and toxicity over time § Potential for resistance: current agents being studied are used for HIV treatment § Adherence for healthy people § HIV testing would be required for Pr. EP access and on an ongoing basis § With limited resources for HIV treatment, is it appropriate to use ARVs for prevention? § Delivery in resource limited settings

The Pr. EP Pipeline § Oral: largely based on tenofovir § Topical: robust pipeline with many compounds being considered § Injectable: TMC 278 LA

Thank you!