PrEP May Not Be Working As It Should For Some Users

December 09, 2019
by John Kelly, MD
PrEP May Not Be Working As It Should For Some Users

A 34-year-old gay man who began taking pre-exposure prophylaxis in December 2018 and was taking it every day was diagnosed with HIV in July 2019.

Most cases where people are diagnosed with HIV while using PrEP is usually the result of not taking the medication properly – missing doses or not taking it as it should be.

However, the man who kept a diary detailing when he took the medication is making researchers wonder if the medication is failing to protect users. And, the researchers cannot say for sure the man didn’t miss a dose or two leading to the diagnosis.

Is PrEP Failing To Protect Users

The case details were presented at the 17th annual European AIDS Conference.

NAM/AIDSmap participant Matthew Hodson said there were several factors that could be the reason for PrEP failing. He said the only reason the case was brought to life was how rare the circumstances are. There have only been a minute number of cases where a person who has been taking PrEP was also diagnosed with HIV.

Hans Benhamin Hampel, with the Zurich University Hospital, told conference attendees that it couldn’t be possible to prove a person was completely PrEP-compliant when they contracted the virus. He said the community would like to say the patient was non-compliant because it was a simple reason for their HIV status.

Hampel said there might be more reasons than non-compliance for an HIV-positive result.

He said PrEP, when taken properly, is still 99 percent more effective at preventing HIV than people who don’t have HIV but have sexual intercourse with those who have unsuppressed HIV.

The man is currently using an antiretroviral therapy with his viral load virtually undetectable, which means he cannot pass HIV onto his partners. Only a handful of noted cases of people with HIV caught it while using PrEP.

In Sydney, Australia, a 27-year-old man was diagnosed with HIV even though he was using a preventative medication. He had been using it for six years before his diagnosis.

Research shows that PrEp can be 99 percent effective at stopping the spread of HIV when the pill is taken every day.


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