Clinicians, researchers and representatives from Montreal’s gay community are joining forces to launch a major study, the IPERGAY trial (CTN 268), to evaluate the effectiveness of the drug Truvada in preventing HIV acquisition among individuals who are uninfected but at high risk. If it proves effective, this approach could contribute to eliminating the transmission of the virus that causes AIDS.
In a context in which gay and bisexual men are disproportionately affected by the epidemic (in Montreal, HIV prevalence within this population is estimated to be 13%), community members are mobilizing to assess how new prevention strategies can be added to existing approaches such as condom use.
The IPERGAY study involves comparing the drug Truvada to a placebo (a pill with no active ingredients). Participants will also receive prevention counselling, condoms, and other support, and their well-being will be closely monitored throughout the study. In addition, all participants will be tested for HIV at regular intervals and comprehensive medical care will be provided if an infection is detected. Part of an international study, the trial aims to include approximately 500 men who have sex with men in Quebec, who will be enrolled for 4 years. The Montreal study site will be based at CHUM-Hotel-Dieu in collaboration with clinics specializing in HIV treatment and community groups who do outreach to men who are potential candidates for the study.
The concept of daily pre-exposure prophylaxis (taking the medication every day on an ongoing basis) has shown some efficacy in previous studies. However, the success of this approach is dependent on the drug being taken very consistently each day, which can be difficult to maintain over a long period especially among individuals who are not sick. Daily pre-exposure prophylaxis is already starting to be used, but only on a very limited basis. For this reason, we want to rigorously evaluate a different concept, “on-demand” prophylaxis (taken when needed based on the frequency of sexual relations) that has not yet been scientifically validated. Our goal is to learn whether this approach is effective in preventing HIV infection, how easy it is to maintain over the long-term, and how it can be integrated into overall HIV prevention efforts in Montreal.
In the fight against HIV/AIDS, we are living in a period of renewal that has given new hope that an AIDS-free generation may one day be possible. Since the beginning of the epidemic, concerted efforts within the communities hardest hit by the virus as well as by clinicians and researchers have succeeded in transforming a fatal disease into a manageable chronic illness and have inspired belief in the possibility of its eventual eradication. We are now, once again, gathering our forces to advance the fight one step further.
For more information about the IPERGAY study, please contact: Ms. Pascale Arlotto, 514-890-8000 ext 15195;
Cécile Tremblay, MD, FRCPC, Principal Investigator, IPERGAY Study – Quebec; Centre Hospitalier de l'Université de Montréal (CHUM); Institut National de Santé Publique du Québec
Mark Wainberg, PhD, Professor, Lady Davis Institute, McGill University
Robert Rousseau, Executive Director, REZO – Santé et mieux-être des hommes gais et bisexuels
Ken Monteith, Executive Director, COCQ-SIDA
Joanne Otis, Canada Research Chair in Health Education (CReCES), UQAM
Thomas Haig PhD, Coordinator, SPOT Project, CReCES, UQAM
Pascale Arlotto, Research Coordinator, CHUM
Gabriel Girard, PhD, Concordia University
Benoit Trottier, MD, Clinique L’Actuel, CHUM
Jean-Guy Baril, MD, Clinique Quartier latin, CHUM
David Thompson, President, Board of Directors, RÉZO
CTN researcher, Dr. Cécile Tremblay is an infectious disease specialist based at the University of Montreal's Faculty of Medicine. Dr. Tremblay is also the Director of Quebec's public health laboratory and she is the Canadian principal investigator for the CTN 268 ANRS IPERGAY trial