Vaccine and Infectious Disease Division

The risks of prophylactic treatment for HIV

HIV antiretroviral therapy (ART) can be used as an emergency preventative measure immediately following high risk sexual behavior, like a plan B for HIV.  While the effectiveness of this treatment  at preventing HIV acquisition is not known, studies show that it may reduce HIV transmission by as much as 80 percent following high risk sex.  The treatment has been available in the U.S. since 1997, but is not widely used.  Some in the public health community have raised concerns that the prophylaxis’ availability may increase risky behavior.  To learn more about the behavior of prophylactic treatment users, VIDD senior staff scientist Dr. Deborah Donnell and colleagues surveyed participants of the HIV-prevention EXPLORE study, 4,295 U.S. men who have sex with men.

As in past studies, the researchers found low use of the prophylactic treatment, with approximately 2 percent having used it before the trial started, and approximately 6 percent during the trial.  More than half of the participants were not aware of the treatment’s existence.  Importantly, while the men who had used the treatment on the whole were more likely to practice high risk sex than those who hadn’t used it, those men did not increase their sexual risk following use of prophylaxis treatment.

Donnell D, Mimiaga MJ, Mayer K, Chesney M, Koblin B, Coates T.  Use of Non-Occupational Post-Exposure Prophylaxis does not Lead to an Increase in High Risk Sex Behaviors in Men Who have Sex with Men Participating in the EXPLORE Trial. AIDS Behav.