Big news in the fight against HIV: Kaiser Permanente, San Francisco's biggest private insurer, says that over a 32-month period, not a single one of its clients taking Truvada contracted HIV. Truvada is the name of the daily pre-exposure prophylaxis, or PrEP, pill that the CDC recommended for use in at-risk populations earlier this year. The new study followed 657 San Franciscans (all but four of them gay men) who asked their doctors for Truvada, and found that while condom use did decline—a major fear of PrEP critics—no one contracted HIV between mid-2012 and February of this year, the New York Times reports. More than 40% of the subjects said they used fewer condoms after starting Truvada, the San Francisco Chronicle reports, and while half of the subjects got syphilis, gonorrhea, or chlamydia within a year of starting PrEP, the Times notes most sexual infections other than HIV can be cured with antibiotics.
And rates of those infections were already climbing among gay men before PrEP came on the market, a doctor notes. This was an observational study of the $50-a-month drug; a clinical trial last year actually gave some participants a placebo instead of Truvada. That study, however, was stopped early—because it became so obvious that Truvada worked that it was unethical to keep some of the subjects on a placebo. This new study "takes it out of the realm of clinical trials and into the real world," one doctor and infectious disease expert says. An AIDS activist echoes that, noting the study "fills in a critical gap by showing that PrEP can prevent infections in a real-world public health program." "This is very reassuring data," adds the lead author of the new study. "It tells us that PrEP works even in a high-risk population." According to ABC 7, the study population also included "injection drug users."