Government starts trial with HIV prevention medication PrEP

The Dutch government is going to distribute PrEP, a medicine which reduces the risk of HIV infection, to men in a ‘high risk group’ for a period of five years. This was announced on Tuesday by Minister for Medical Care Bruno Bruins.

PrEP is an anti-retroviral medication that reduces the risk of HIV infection by about 90 per cent. The medication is prescribed in a research setting in which participants receive medical care every three months. The trial is going to cost 22 million euros but is expected to save 33 million euros in health care costs, according to the Minister.

The government wants to use the trial to investigate whether the risk group – men who have sex with men – is reached, whether the number of HIV infections actually decreases and whether there is medication adherence. PrEP only protects against transmission of HIV and not of any other sexually transmitted infections. The trial must also show whether distribution of the medication influences the approach to other STI’s.

The National Institute for Public Health and the Environment (RIVM) estimates the number of participants in the trial on 6.500. By prescribing the medication, he Minister hopes to prevent 250 HIV infections yearly.

Advice Health Council

The trial comes in response to the advice of the Health Council issued in March this year. The advisory report stated that every year 800 people in the Netherlands are infected with HIV, of which two-thirds consists of men who have sex with men.

Although measures such as raising awareness and stimulating STI-testing and condom use do have an effect, the Health Council predicts that a continuation of this policy does not lead to a further decrease in the number of HIV infections in the risk group. The Council therefore advised to start a trial with PrEP, which could help to reduce the number of new HIV infections further.

Bruins also expects that the trial with PrEP will have more positive outcomes besides cost savings and reducing the burden of disease: ‘By reducing fear and stigma, among others, PrEP contributes to the mental and social wellbeing of the user. In this way, PrEP can have a clearly positive impact on the quality of life, and the absence of chronical illness makes it possible to fully participate in society.’

At the end of this year it should become clear how the trial is to be carried out by the RIVM and GGD. Bruins is hoping to start the nationwide trial next year.

The pill costs 48 euros per month. The government reimburses 75 per cent of the costs, which brings the participants’ personal contribution to 12 euros per month.

Read the article on the NRC website (Dutch only).

 

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