HIV prevention does more than just prevent new infections

Besides providing protection from spreading human immunodeficiency virus (HIV), the drug Truvada can also be effective in connecting high-risk individuals with the healthcare system and engaging them with proper care.

Researchers at St. Michael's Hospital developed a mathematical model to predict the impact on the benefits and cost effectiveness of HIV treatments including pre-exposure prophylaxis (PrEP). The model measures the impact of PrEP on the number of new HIV cases in gay men in Toronto while evaluating the rates of protections the offered by Truvada. The findings were published Oct. 5 in the Journal of the International AIDS Society.

When evaluating Truvada, the team found the drug could reduce HIV acquisition by 44 percent—or up to 99 percent with strict adherence to physicians' orders. Testing also showed that over a period of 20 years, PrEP being used in 25 and 100 percent of gay men at highest risk would be able to prevent 1,166 and 3,012 new HIV infections and 70 and 140 HIV-associated deaths.

The men who adhered to their medication regimens also came into more contact with healthcare professionals. This additional contact means they are getting HIV tested more regularly and having regular checkups for other health concerns. The prevention associated with these additional healthcare visits saves the system around $11,359 per prevented infection, according to the researchers.

"This study makes a strong argument for public reimbursement of this drug," said Darrell Tan, MD, lead author of the study, in a statement. "It's more evidence the drug is both clinically and cost effective when targeted at men at highest risk. A large benefit comes from engaging non-diagnosed HIV-infected men into care."