New injectable PrEP on the horizon shows incredible promise

[Bwana_LB 3,304]

(Copied from elsewhere. No indication of how long approval might take or cost, but this is a huge improvement on the best PrEP available now)

 

Gilead, a California based pharmaceutical company, announced on Thursday (20 June 2024) that it was ending the phase 3, blinded clinical trial of its new, twice-a-year shot for pre-exposure prophylaxis (PrEP) against HIV, lenacapavir, because it is too effective.

In this sort of clinical trial, some participants are randomly assigned to the new intervention that's under investigation (i.e. lenacapavir) and some are randomly assigned to the current standard of care (i.e. Truvada or Descovy, PrEP pills that must be taken every day). Why? Because it would be unethical to use placebo when we know that once-daily PrEP pills do prevent HIV.

The trial is also "blinded" to prevent investigator bias from influencing the results – to the maximum extent practicable, the investigators carrying out the research do not know, while the trial is being carried out, which participants are getting which treatment, nor do they know how effective those treatments are.

But an Independent Data Monitoring Committee (IDMC) has access to all of the data. The IDMC can see, while the trial is ongoing, which participants have gotten which interventions, and they can see how effective those interventions are.

The IDMC saw that none of the 2,134 women who received the twice-yearly injection of lenacapavir developed HIV. 0 cases of HIV in any of the participants assigned to lenacapavir.

There were 16 cases of HIV in the 1,068 women assigned to Truvada. There were 39 cases of HIV in the 2,136 women assigned to Descovy.

At that point, the IDMC has an ethical duty to recommend the blinded trial be stopped, and all of the participants assigned to Truvada and Descovy be offered lenacapavir. Why? Because they know lenacapavir works, it is superior to either Truvada or Descovy, and once that fact has been established, it would be unethical to deny participants the option to receive the more effective PrEP option of lenacapavir.

Lenacapavir is not the first injectable PrEP agent. FDA approved "apretude" in 2021; it must be injected every other month. The game changing nature of lenacapavir is that it only requires two injections per year in order to achieve 100% efficacy.

[Unavowed 2,133]

Be cautious about drawing the conclusion that current medication is not effective based on what the article says. The efficacy of current medication is incredibly high, and it’s more likely that the infections are as a result of missing taking a tablet or mixing up timing. An injection twice per year would certainly take the hassle and risk out of that equation if approved.


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[JackJohn 676]

I have been reading a bit about this injectable PreP. When on one of my binges/splurges and having fun with a ladyboy daily, I usually take oral PreP. 

It's not because I fuck them BB (it's a no way for me personally and for sure not when P4P), but just another layer of protection in case of a condom break, slip or whatever. I guess it's more to feel at extra ease for the bbbjs and rimjobs. 

Anyway back to this injection option, I contacted a clinic in Bangkok and they offer it for a whopping 30,000 baht for first batch and then it's another 10,000 baht every 3 months so basically close to 60,000 baht a year. Also the guy was quite rude and kept saying "when you have sex with man" to which I kept saying "yes intercourse with a transgender". I know it's sex with a guy from a biological point of view but it was weird he kept talking over me saying that it is sex with man. 

[lbshagger 231]

Which clinic was that you enquired about the lenacapavir. I went to the BHP today for a refill of ARV's and we discussed Lenacapavir, my Dr said it wasn't yet approved in Thailand. I think Cabotegravir is approved though, around 15,000 a jab every 2 months.

Lenacapavir when combined with one other drug taken orally is in phase 3 trials for treatment. Once a week and 100% efficacy in phase 2 trials. Will be the go to drug later.

 

[JackJohn 676]

Safe Clinic. It might be the same variant of medication you mention but their prices rack up to close to 60,000 baht a year. I've been taking regular oral PreP which is around 2000 baht a month. And can also just use as demand PreP with 2-1-1 adherence which is fine for me as I'm drifting in and out of these activities. 

Again, I'm not doing BB so it's only as that later for blowjobs with cum in mouth, rimjobs etc. I guess the extra layer gives me the psychological peace. 

[ThaiHard 114]

1 hour ago, JackJohn said:

Safe Clinic. It might be the same variant of medication you mention but their prices rack up to close to 60,000 baht a year. I've been taking regular oral PreP which is around 2000 baht a month. And can also just use as demand PreP with 2-1-1 adherence which is fine for me as I'm drifting in and out of these activities. 

Again, I'm not doing BB so it's only as that later for blowjobs with cum in mouth, rimjobs etc. I guess the extra layer gives me the psychological peace. 

Previously, I had bought PrEP some years ago at Pulse clinic in Pattaya. A few weeks ago, after a successful negotiation with the wife for a P4P trip (Bangkok in August), I emailed Pulse and explained I couldn't come to Pattaya, but I had a negative HIV test and normal kidney function test  - and then asked if I could buy the Teno-EM I had bought before online. They did not have that particular brand but a different generic Tenof-EM (!) and it cost 1,100 baht (with 200 baht for delivery). Took 3 days to get here (Thailand, up norf).

I am not sure if that's the normal online price or if it was because I was a previous customer, but it's worth asking. Earlier, I had found a different price list online and was going to buy but the 'normal' Pulse website required a prescription. I emailed them direct and they sent back a direct link to the purchase page which did not require prescription upload.

[Bwana_LB 3,304]

Be wary of any injectables offered in Thailand. First, the newest are NOT available in any generic formulation and so will be quite expensive. And second, Thailand's CDC has not approved any of them for use, so what may be available is an unapproved generic from India that has not been tested. Thailand tests new PrEP drugs in Thailand before approving them.

[JackJohn 676]

14 hours ago, ThaiHard said:

Previously, I had bought PrEP some years ago at Pulse clinic in Pattaya. A few weeks ago, after a successful negotiation with the wife for a P4P trip (Bangkok in August), I emailed Pulse and explained I couldn't come to Pattaya, but I had a negative HIV test and normal kidney function test  - and then asked if I could buy the Teno-EM I had bought before online. They did not have that particular brand but a different generic Tenof-EM (!) and it cost 1,100 baht (with 200 baht for delivery). Took 3 days to get here (Thailand, up norf).

I am not sure if that's the normal online price or if it was because I was a previous customer, but it's worth asking. Earlier, I had found a different price list online and was going to buy but the 'normal' Pulse website required a prescription. I emailed them direct and they sent back a direct link to the purchase page which did not require prescription upload.

Teno-EM I have also taken and it's around 1200-1500 for 30 day course. Very minimal side effects for me personally, but the kidney function test is important to check. I guess depends on the clinic and their mark up etc. Some need a recent test, others can accept if 3 months old. As like with most things in Thailand, you need to find a reliable place that sells the best version at a reasonable price. I don't mind if it's a few hundred baht more or less if it gives me the convenience. The thing that annoyed me about the above mentioned clinic was the guy being arrogant in many ways. 

I felt like he was being a bit patronizing when he kept saying "when you have sex with man" not too mention very unprofessional. So anyway fuck it, so much choice and I go simply elsewhere to buy the exact same thing without the attitude. 

[JackJohn 676]

12 hours ago, Bwana_LB said:

Be wary of any injectables offered in Thailand. First, the newest are NOT available in any generic formulation and so will be quite expensive. And second, Thailand's CDC has not approved any of them for use, so what may be available is an unapproved generic from India that has not been tested. Thailand tests new PrEP drugs in Thailand before approving them.

Yes and I don't mind the oral 2-1-1 dosage for those days I am down for some LB action. The effectiveness is supposed be upwards in the 90% and if you can find an LB on PreP as well it's even more assuring. Needless to say just don't ever BB and use protection... The PreP makes me feel less anxious after all those episodes lol.