Men at particular risk for HIV are very likely to consistently take preventative medication during vacations when their odds of contracting the virus are higher, according to a study conducted by researchers at the University of Pittsburgh.

The findings indicate that short-term use of pre-exposure prophylaxis (PrEP) medication could be a successful way to prevent the spread of HIV in men who have sex with men (MSM) and who have difficulty with long-term PrEP use. In addition, it may work to transition men to long-term PrEP, which has been shown to be highly effective in reducing HIV transmission, according to the study.

“We started this as a feasibility study to see if we could identify barriers to short-term PrEP use and make adjustments. But we were excited when we got the results and discovered that almost all the participants were adherent to the point of protection against HIV,” said study author James Egan, PhD, MPH, assistant professor of behavioral and community health sciences at Pitt Public Health, in a press release. “This gives us a promising strategy to pursue in engaging at-risk men in HIV prevention efforts that work for them.”

The research team followed 48 MSM from Pittsburgh or Boston in a pilot program to test the daily use of PrEP for 30 days, which included an out-of-town vacation, with the men starting the medication 7 days before the trip and continuing for at least 7 days after vacation. In addition, the men were given a brief session introducing them to the use of PrEP.

According to the study authors, 94% of the men had blood concentrations protective against HIV after their vacations, consistent with regular use of the medication. Moreover, nearly 75% reported condomless sex during vacation, while about one-third reported recreational drug use.

None of the men contracted HIV during their vacation, though one of the men contracted the virus during the 3-month post-vacation follow-up period when he had a lapse in use of PrEP associated with loss of health insurance and a move to a new city. Additionally, 70% of the participants indicated an interest in continuing daily PrEP use long-term.

“That really stood out to us,” said senior author Kenneth Mayer, MD, medical research director at The Fenway Institute at Fenway Health in Boston and professor of medicine at Harvard, in a press release. “It shows us that introducing short-term use of PrEP before a vacation could lead to longer-term use. This presents an enticing opportunity to reduce HIV transmission.”

The study had limitations, including only involving men who were motivated to enroll and did not address the likelihood of physicians prescribing PrEP for short-term use, the ease of obtaining PrEP for use only during vacation, or the impact of the study’s brief counseling on the use of PrEP.
 
“These are all areas that our findings suggest warrant future explorations,” Egan said. “Our study tells us short-term adherence to PrEP during high-risk periods is tolerable in men who have sex with men, and that it could lead to long-term use. Now we need to determine how to make it possible in the real-world setting.”

REFERENCE
Short-term use of HIV-prevention medication protects at-risk men on vacation. UPMC. https://www.upmc.com/media/news/081220-hiv-prevention-medication-protects-men-on-vacation. Published August 12, 2020. Accessed August 20, 2020.