July 1 (UPI) -- The rate of new HIV infections among men who have sex with men remained low during a three-year period in a region of Australia in which a drug to prevent spread of the disease was affordable and widely available, according to a study published Thursday by The Lancet HIV.
During the three years that the drug therapy called pre-exposure prophylaxis, or PrEP, was available and affordable, 30 new HIV infections were reported, for an infection rate of 1.61 cases per 1,000 people per year, the data showed.
This is roughly 92% lower than the expected rate of at least 20 cases per 1,000 people per year, the researchers said.
"Our analysis ... provides important insights into the longer-term benefits of PrEP, demonstrating that it remains highly effective in preventing HIV among men who have sex with men," study co-author Dr. Andrew Edwin Grulich said in a press release.
"There are still many global settings where PrEP is not widely utilized or accessible. We urge policymakers around the world to recognize that access to affordable PrEP has reduced HIV transmission," said Grulich, a professor of epidemiology at the University of New South Wales.
Previous studies have shown that PrEP, which is a cocktail of antiviral medications, is safe and effective at preventing up to 99% of HIV infections, at least for short-term use, particularly among men who have sex with men.
However, only 15% of the more than 1.1 million people in the United States deemed candidates for the regimen by the Centers for Disease Control and Prevention have been prescribed it, research suggests.
For many, cost may be an issue, as a 30-day supply of the regimen is priced at about $2,000 in the United States, and insurance coverage varies from plan to plan, although many advocacy groups offer it at reduced cost for people at high risk, according to researchers.
For this study, the researchers tracked nearly 9,600 men in New South Wales, who were given a three-month supply of PrEP at least once between March 1, 2016, and April 30, 2018.
Participants were, on average, age 34, with 92% identifying as gay and 7% identifying as bisexual.
All new HIV cases among study participants occurred in those not taking PrEP daily at the time of infection, according to the researchers.
New HIV infections were lowest during the first year of the study period, at 1.09 cases per 1,000 people per year, before increasing to 2.10 and 2.18 infections per 1,000 people per year in the second and third years, respectively.
Being younger, living in areas with fewer gay men, reporting more behaviors linked to HIV risk and lower PrEP adherence also were associated with increased infection rates, the researchers said.
The rate of new HIV infections was 1.05 per 1,000 people per year in men who reported one risk behavior, compared with 7.23 cases per 1,000 people per year in those who reported four or five behaviors.
"In places like Australia, there are now very few barriers to taking PrEP, [which] can be accessed through gay-friendly clinics, and medications, clinic visits and lab testing are highly subsidized or free," study co-author Rebecca Guy said in a press release.
"This is, of course, not the case in many parts of the world, and indicates the need to identify and address barriers to PrEP access in other settings," Guy said.
