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1. HIV PrEP: Rising Use, Promising New Truvada Data, More Future Options

PrEP, or pre-exposure prophylaxis to prevent HIV infection, was the major HIV topic in the mainstream media in 2014. 

In May new guidelines from the U.S. Centers for Disease Control and Prevention (CDC) recommended daily Truvada (tenofovir/emtricitabine)PrEP for people at "substantial risk" for HIV infection, and in July the World Health Organization (WHO) advised that at-risk gay and bisexual men should consider PrEP.

While the AIDS Healthcare Foundation waged an advertising campaign questioning the effectiveness of Truvada PrEP -- and calling into question how efficacy is measured and reported in studies -- experts agreed that PrEP works if you take it consistently, and many people can do so. New data from the iPrEx Open-Label Extension study presented at the International AIDS Conference showed no new infections among gay men who took Truvada at least 4 times per week. While only about one-third achieved this level of adherence, men at higher risk were more likely to do so. This was followed by promising interim findings from the U.K. PROUD study and the French IPERGAY trial of "on demand" PrEP, leading study safety committees to offer PrEP to all participants.

Looking at real world use, a pharmacy survey by Truvada manufacturer Gilead Sciences found that PrEP use is increasing in the U.S. and that gay men make up a growing proportion of users. In December clinicians from Kaiser Permanente in San Francisco reported that no new HIV infections have occurred among more than 500 PrEP users. San Francisco, Washington State, and New York State were among the first locales to promote and help fund PrEP as a public health measure.

Looking to the future, early studies showed that long-acting injectable cabotegravir (GSK1265744) was protective in monkeys and appears promising in humans. But on a cautionary note, studies and models increasingly suggest that PrEP may work better for anal sex than for vaginal sex.

NEXT: 2. Harvoni and Viekira Pak: Effective Oral Combinations for HCV Genotype 1