Eric Caumes assaults PrEP: reactions
France – The topic of a number of rigorous scientific research with uncontroversial outcomes, PrEP is really useful by theSGDthe HASthem CDC Individuals and well being authorities in lots of nations. On the event of the discharge of his ebook “Intercourse, the brand new risks” Ed. Bouquins, the Professor Eric Caumesformer head of the infectious illnesses division at Pitié-Salpêtrière (Paris) however reiterated his place towards PrEP within the columns of The Specific.
For him, it could be a preventive therapy that may lead a inhabitants of males who’ve intercourse with males to pose a well being danger to all the inhabitants. Sufficient to make infectious illness specialists bounce at a time when the deployment on the town of the prescription of PrEP begins.
Some have determined to reply by means of the press, such because the epidemiologist Dominique Costagliola, recipient of the Inserm 2020 grand prize who additionally spoke within the weekly cited above, others abstained fearing that talking would additional publicize the ebook.
Nonetheless others have chosen to publish a column on the hiv.org web site which takes up and contradicts level by level the arguments of Professor Caumes. Its title: “In 2022, we are able to not be towards PrEP! “.
Requested by Medscape French versionthe Professor Gilles Pialouxhead of the infectious illnesses division on the Tenon hospital but in addition vice-president of the French Society for the Combat towards AIDS (SFLS), editor-in-chief of vih.org and who can also be one of many managers of the Formaprep website “feels[t] the responsibility to battle towards misinformation and confusion that might curb docs who can now prescribe PrEP within the metropolis”.
“Something that undermines what relies on science may be very disturbing, particularly after the decline in confidence in medical info in the course of the covid disaster. Particularly when it comes from a specialist in sexually transmitted infections. This forces consultants to place certainties again into scientific actuality. Sure, PreP may be very efficient towards HIV when taken effectively, as much as 96 to 99% for the higher restrict of the boldness interval within the Ipergay and Proud trials. And sure, Prep is cost-effective in goal populations, particularly since it’s generic. No, it doesn’t shield towards STIs, however the sexual well being supply related to it makes it doable to detect and deal with them from the asymptomatic stage. A lot so that folks on PrEP are among the many greatest screened for STIs,” says the infectiologist.
A rise in STIs attributable to Prep?
This isn’t the primary time that Professor Caumes has come out towards HIV pre-exposure prophylaxis (PrEP), which he accuses of being the reason for the resurgence of STIs. This truly predates the arrival of PrEP, which is prescribed at the moment to lower than 30,000 folks in France.
“We now have seen this improve within the incidence for the reason that starting of the 2000s, whereas the primary trials of PrEP date from 2012, and its validation in France from 2016”, explains Dominique Costagliola in The Specific. And to conclude: “So it doesn’t appear very cheap to hyperlink the 2. » « Behavioral modification dates again to the mid-Nineteen Nineties with the arrival of tritherapies. We then noticed a rise in anal intercourse with out a condom, with certainly a re-emergence of STIs within the years that adopted” confirms Gilles Pialoux who insists on the truth that “the usage of PrEP doesn’t exclude the sporting of a condom. Prep is a mixed prevention and danger discount device.
Concerning STIs, remember the fact that PrEP is a part of a mixed prevention technique. In actual fact, the prescription of PrEP is accompanied by screening and therapy, if vital, of different STIs. Prescribing docs suggest that their sufferers receiving PrEP be screened for STIs each three months. “With these systematic screenings mixed with the usage of new PCR testing methods, we now discover constructive instances of gonococcal or chlamydia infections in asymptomatic males,” notes Dominique Costagliola. Which means that among the STIs weren’t detected earlier than insofar as they had been solely appeared for within the occasion of signs. This could clarify a part of the noticed improve.
Don’t equate STIs and HIV
“STIs are growing and we have now to simply accept it even when PrEP alone can’t be known as into query”, considers Gilles Pialoux. Nonetheless, he needs to make clear a vital level for him on this revived debate. “It’s fully absurd to equate HIV an infection and Chlamydia an infection. We aren’t on the identical register, ”he insists. As a result of STIs are illnesses that may be handled very effectively at the moment, whereas AIDS stays a illness with impacts for the affected person and society which can be heavy to bear: lifelong therapies and sure careers prevented.
” He [ndlr : Eric Caumes] neglect the immense burden of AIDS, borne by males who’ve intercourse with males (MSM) for nearly 20 years, till the arrival of triple therapies (…): hampered sexuality, an infinitely painful illness and painful, spouses, lovers, mates who die week after week, a lifetime of mourning and concern”, accuses the publication of the editorial employees of vih.org which denounces a discriminatory ethical place below the guise of scientific argument.
“The AIDS years are alleged to have opened us as much as a sure tolerance. We can’t return on the achievements of those 40 years of combating AIDS by way of danger discount with out judging practices. Science isn’t opinion. Nevertheless, when there’s a very efficient prevention device that gives greater than 95% safety towards HIV an infection, what could be the duty of the physician who decides to not prescribe it, in a complete sexual well being supply, to an individual with dangerous conduct who doesn’t shield himself with different means”?
Funding and hyperlinks of curiosity
Gilles Pilaoux: Invitation to a congress, participation in a board or conferences for: Gilead, MSD, Bristol-Myers Squibb, Janssen, Abbvie, AAZ.
Dominique Costagliola declares having hyperlinks of curiosity with: Gilead (Board VIH France, from January 2011 to December 2015), Innavirvax and Merck Switzerland (consultancy in 2015 and 2016), Janssen (exhibition in 2016 and 2018), MSD (in 2015 and 2017), and ViiVhealthcare (in 2015).
Éric Caumes has hyperlinks of curiosity with Pfizer and Valneva.
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