Investigating use of new HIV prevention strategy

Wales is about to become one of the first countries to robustly examine the use of a new HIV prevention strategy that has been rolled out across the world.

Dr David Gillespie, Deputy Director of Cardiff University’s Infections, Inflammation and Immunity Division, will lead the research after winning a Health Research Fellowship award funded by Welsh Government.

Pre-Exposure Prophylaxis, or PrEP, is a prevention strategy in which HIV-negative people take drugs, usually used to treat HIV, to reduce their risk of becoming infected with the disease. It is for people who are at increased risk of getting HIV from their sexual behaviour or their potential exposure to the infection.

Dr David Gillespie said: “While the PrEP drugs are proven to reduce the chance of HIV-acquisition by up to 86%, there has been very little evaluation of how these drugs are being used in conjunction with sexual behaviour over time, and whether their use can be improved to increase their efficacy further.”

Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething, announced his decision to make PrEP available across Wales as part of a three-year trial period in 2017. The medication contains two drugs (tenofovir disoproxil fumarate, or TDF, and emtricitabine, or FTC) which have been used for many years to treat HIV. This drug combination has been licensed for use as PrEP in the US since 2012 and Europe since 2016.

The study will monitor the extent to which patients take their medication as prescribed, recording whether and when a medication is started after being prescribed, if it is taken as prescribed, the length of time the medication is taken for, and whether the person has engaged in any behaviour which might have exposed them to HIV.

On average, over the past six years, there have been approximately 153 new cases of HIV infection diagnosed annually in Wales. The vast majority of infections were sexually transmitted.

Professor Kerry Hood, Director of the Centre for Trials Research, said: “This fellowship draws together the Centre’s programmes of research around infections and medication adherence and will provide services with a better understanding of how to optimise medication use in practice, particularly where medications are being taken to maintain health rather than to treat disease. This will be world leading research that can influence the services for people at risk of developing HIV across the UK and beyond.”

Dr Gillespie’s fellowship will be based at the Centre for Trials Research at Cardiff University - the largest group of academic clinical trials staff in Wales.