Medicine that lowers chances of HIV infection found safe among MSM, transgender women: Study

India has successfully reduced HIV incidence with a 66 percent decline since 2000. However, control among MSM and TGW remains a challenge. Till date there are no studies to evaluate the feasibility of oral PrEP among MSM and TGW in India.

Pre-Exposure Prophylaxis (PrEP), an oral biomedical HIV prevention, has revolutionised HIV prevention efforts worldwide. This preventive strategy is particularly recommended for individuals in high-risk groups who are not living with HIV but are at increased exposure risk for HIV, such as female sex workers, Men Having Sex with Men (MSM) and Transgender Women (TGW).

“Despite the proven efficacy studies, real-world challenges of PrEP remain unknown in India,” study research scientists said. Hence they undertook the first demonstration project among Men Having Sex with Men (MSM) and Transgender Women (TGW) in India to understand the feasibility of delivering PrEP through clinic and community-based service delivery models.

Dr Sahay, who led this project, stated that a total of 650 MSM and TGW were enrolled at Pune, Maharashtra and Jalandhar, Punjab sites.

Each participant was followed up for 12 months after PrEP prescription by a healthcare provider.

“The use of PrEP can lower one’s chances of getting HIV from sex. We found PrEP to be acceptable and safe among MSM and TGW in the project. As a key component of comprehensive HIV prevention efforts, PrEP works alongside measures such as regular HIV testing and consistent condom use. With advancements like long-acting injectable formulations on the horizon, PrEP is poised to play an even more significant role in reducing the spread of HIV worldwide,” Dr Sahay said.

In 2023, around 5.4 million of 39.9 million people living with HIV worldwide – one in seven – were not aware of their status. At the same time 9.3 million – nearly one in four were not receiving life-saving treatment.

Dr Ishwar Gilada, President Emeritus, AIDS Society of India, pointed out that India is home to an estimated 2.54 million people living with HIV (PLHIV), making it one of the most affected countries. “Globally at rank three after South Africa and Nigeria. Efforts by NGOs and National AIDS Control Organisation (NACO) have resulted in a 48 per cent decline in new infections between 2010 and 2021. Yet, with nearly 68,000 new infections annually, awareness and early intervention remain critical to achieving a future free of HIV,” Dr Gilada pointed out.

Experts have said that despite significant advancements in long-acting PrEP and treatment, these technologies are largely out of reach in low and middle–income countries. High drug prices, restrictive licencing and limited manufacturing capabilities are likely to hinder the rollout of long acting PrEP products, IAS experts have said.