A preventive treatment against AIDS taken during sexual intercourse currently being tested in France as part of the Ipergay clinical trial has just proven its effectiveness.
“A great success in the fight against HIV / AIDS,” announced the National AIDS Research Agency (ANRS) in a press release published on Wednesday. This great success is that of Truvada, an antiretroviral taken to prevent AIDS. This strategy is currently being tested within the framework of Ipergay, a clinical trial conducted by the ANRS.
An 80% reduction in the risk of infection
Launched two and a half years ago with 400 homosexual volunteers, Ipergay is based on an innovative concept: PrEP (pre-exposure prophylaxis). This method consists of taking a treatment against a disease as a preventive measure, that is to say before contamination. If the previous trials of Prep with Truvada, carried out in particular in England and the United States have proved to be unreliable with relatively low efficacy rates, the ANRS announces a completely different result. Indeed, according to the agency, Ipergay has shown that the risk of HIV infection can be reduced by 80%. Almost twice as effective as the IPREX trial conducted in the United States and whose protection was evaluated at 42%.
Before and after intercourse
Unlike these previous experiences, the ANRS trial has the originality of being administered only before and after intercourse. In other words, “on demand”. “This treatment is aimed at HIV-negative people who take risks, for example by having sex with HIV-positive partners or people who have not been tested for example”, explains Prof. Jean-Michel Molina, coordinator of the IPERGAY test. To determine if the treatment is effective, the trial requires placing one group on antiretroviral and another on placebo (a lump of sugar is given instead of the Truvada tablet). The study is also carried out double-blind, meaning that neither the doctors nor the participants know whether they are actually taking the treatment or the placebo.
Listen to Prof. Jean-Michel Molina, coordinator of the trial: ” This treatment is for HIV negative people who take risks exposure to the virus“
Controversy within the homosexual community
However, the Ipergay trial is not unanimous. For Dr Olivier Taulera, this treatment corresponds to “anti-prevention”. This Parisian general practitioner considers that taking Truvada keeps people away from other prevention methods, in particular wearing a condom. “And I’m not even telling you about the side effects of Truvada, which are very severe, especially for those who are HIV negative. Rhenal insufficiency, osteoporosis, ”adds the latter. Dr Taulera is not the only one to be critical. The controversy even extends to the homosexual community. A Toulouse anti-AIDS association is mobilizing against the use of Truvada. It is based in particular on the results of a previous study carried out in the United States saying that these results would only be reliable to 50%.
Listen to Prof. Jean-Michel Molina, coordinator of the trial, ” It is a fantasy to imagine that people will abandon prevention methods in favor of Truvada. “
Straight guys are also affected
There is also the question of people said to be “exposed to the risk of infection”. In fact, since the study only included homosexuals, can the preventive treatment with Truvada also be applied to heterosexuals? “The data obtained in the context of Ipergay are very likely to be extrapolated,” suggests Professor Molina. The latter also recalls that gays only represent 40% of the 6,000 French people infected each year. “This research is a great advance in the prevention against AIDS not only in France, but also in the rest of the world”, concludes Professor Molina.
“These initial results leave no room for doubt: this new prevention strategy is effective beyond our expectations,” said Bruno Spire, president of AIDES, for his part. We can no longer afford to wait for the final results of the trial (available in spring 2015) to make this new tool available to everyone at risk. And this, regardless of their gender or sexual orientation, ”he explains. The ANRS already recommends that all participants in the Ipergay trial have access to Truvada for prevention.
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