HIV rates have dropped by about one third among men who have sex with men (MSM) and PrEP has a lot to do with that.

The latest HIV figures revealed the lowest number of transmissions since 1985 in Australia’s biggest state, New South Wales (NSW). Researchers described them as ‘globally unprecedented reductions’.

NSW was the first state to introduce a government funded trial into PrEP called (EPIC-NSW). PrEP(pre-exposure prophylaxis) is an effective daily medication to prevent HIV.

The EPIC-NSW trial started in March 2016. It became the first study globally to measure the impact of PrEP on reducing HIV in a large population.

‘The speed of the decline we’ve seen in new HIV infections in gay and bisexual men is a world first,’ said Professor Andrew Grulich from the Kirby Institute at UNSW Sydney which led the trial.

‘In the year following the trial, state-wide new HIV infections in this population decreased by one third, from 149 infections in the 12 months prior, to 102 in the 12 months after. These numbers are the lowest on record since HIV surveillance began in 1985.

‘Our research tells us that these reductions are a result of PrEP, implemented on a background of high and increasing HIV testing and treatment rates.’

Sydney’s ‘gay suburbs’ saw the biggest drop

The declines were highest among Australian-born MSM (48.7%) and MSM living in the ‘gay suburbs’ of Sydney (51.8%).

‘These communities had the highest uptake of PrEP, and in these populations, new HIV infections have halved since the trial began,’ Grulich said.

‘However, we did not see the same reductions across the board. Reductions were lower in non-English speaking immigrants with a smaller 21% decline among those born in Asia. We need to improve education and promote access to PrEP.’

The EPIC-NSW trial enrolled 9,714 HIV negative people at high risk of HIV. It provided them with PrEP until 30 April, 2018.

‘The results from EPIC-NSW provide an important evidence-base to inform our response to HIV globally,’ Grulich said.

‘We now know that PrEP implemented quickly, at a large scale, and targeted to high-risk populations can help turn the HIV epidemic around.’

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