Treatment that Prevents HIV is Studied in Brazil, Mexico, and Peru
The treatment that prevents HIV, known as Pre-Exposure Prophylaxis (PrEP), is showing good results in populations of men who have sex with men (MSM) and in transgender women in Mexico and Brazil, but not in these populations in Peru.
The Latin American PrEP Trial Project (ImPrEP) is a study carried out to identify the necessary elements in order to implement PrEP as a strategy in public health services. It began in 2018 and takes place in 12 cities in Brazil, 6 in Mexico, and 6 in Peru, countries that were selected for having some of the highest HIV prevalence rates in Latin America.
The research seeks to learn more about starting and adherence to treatment and its impact on the incidence of HIV in the aforementioned populations, in addition to factors that can predict which people are more likely to acquire HIV while taking PrEP, and the barriers to access that treatment.
Differences in Results
Partial results of the ImPrEP study were presented at the 11th HIV Science Conference, which took place virtually last July.
To participate in the project, MSM and trans women who do not have HIV were admitted. At the first visit, they were given a supply of PrEP for one month, and then the following visits are scheduled every three months. They conduct HIV testing and behavioral surveys.
As of April 2021, 10,410 people had signed up for the study: 4,165 in Brazil, 3,360 in Mexico, and 2,885 in Peru. Of the total, 84 people acquired HIV, an overall incidence of 0.75%.
When considering the data by country, Brazil registered an incidence of 0.31% and Mexico a 0.44%, however, more than two-thirds of all infections occurred in Peru, where the incidence was 2.42%.
Factors Predicting Infection
According to what was reported in the news portal aidsmap.com, the analysis allowed to identify some factors that can clearly predict HIV infection: Peruvian people and any participant between 18 and 24 years of age have almost four times the risk of acquiring the virus, while those with poor adherence to treatment were three times more likely. In addition, those who have receptive anal sex without a condom are twice as prone to infection.
Dr. Carlos Cáceres, a researcher at the Universidad Peruana Cayetano Heredia in Lima, Peru, presented the data and mentioned some of the possible reasons for the higher number of infections in that country. Among them are that in Peru a greater number of young people were registered, there were more trans women, the people registered have a lower educational level and a low adherence is registered among them.
He also noted that the health centers participating in the study in Peru mainly serve cisgender sex workers and MSM and low-income trans women, compared to centers in Brazil and Mexico, which tend to receive a broader range of those populations.
The researcher indicated that implementing a PrEP program should pay more attention to these early indicators of possible failure, and provide additional support to those who may experience this failure.
If you want more information about PrEP or want to know if it is available in your country, check our services at AHF Latin America and the Caribbean, we can help you.