Study: Combining PrEP With U=U Yields Incredible Results

When people use a combination of HIV prevention methods, researchers found there was a significant drop in HIV transmission.

Published in the academic journal HIV Medicine, the study found that using several methods such as taking PrEP, early HIV diagnosis from frequent testing, and proper antiretroviral treatment decreased transmission by 80 percent.

The research was evaluated at 56 Dean Street, which is a sexual health clinic and part of Chelsea and Westminster Hospital NHS Foundation Trust in London.

“We witnessed an 80% reduction in the number of HIV diagnoses between 2012 and 2017, following the introduction of a number of HIV prevention measures (PrEP introduction, early HIV diagnosis through frequent and facilitated access to HIV testing and timely ART used as treatment-as-prevention) were key to the success of this model,” lead author Nicolo Girometti, told Contagion. Girometti is also a consultant in HIV medicine at 56 Dean Street.

The clinic began HIV and STI health care in 2009, then a smaller location opened for asymptomatic patients with a focus on screening. Other care followed like antiretroviral initiation and PrEP.

“We were humbled to see how the introduction of rapid ART start allowed on one hand to reduce drastically the time to viral suppression (from a median of 520 days to 79 days in six years) and on the other hand to see a high uptake of rapid ART initiation with consistent levels of retention in care,” Girometti told the site.

HIV testing also increased at the clinic between 2012 and 2017 — going from 4,732 per quarter to 10,362. People also started getting tested more than once a year. In fact, the number of patients that got tested at least three times a year went from 957 to 4,553.

Girometti said that the increase in testing was due to a flexible model based on where the clinic was — located in the middle of London’s gay neighborhood of Soho — as well as the engagement of the clinic in the local community. The clinic strategized to attract the most high-risk populations and connect them to free testing with quick turnaround.

“We intend to monitor the trend of HIV infections following the wider introduction of PrEP which started happening in 2018 and will try to establish the impact of [COVID-19] pandemic in testing rates and ultimately HIV diagnoses,” Girometti said.

The model used at 56 Dean Street has already been recognized internationally, including by the U.S. Centers for Disease Control and Prevention.