Public Policy & Advocacy
What is PrEP?
PrEP is short for Pre-Exposure Prophylaxis. It is a new HIV prevention method in which people who do not have HIV take a daily pill to reduce their risk of becoming infected. When used consistently, PrEP has been shown to reduce the risk of HIV infection among adult men and women at very high risk for HIV infection through sex or injecting drug use.
Based on studies to date, in July 2012 the U.S. Food and Drug Administration approved the combination medication tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) for use as PrEP among sexually active adults at risk for HIV infection.
For some individuals at high risk for HIV infection, PrEP may represent a much-needed additional prevention method, but it will not be right for everyone and is not intended to be used in isolation, but rather in combination with other methods to reduce the risk of getting HIV infection. If it is delivered effectively and targeted to those at highest risk, PrEP may play a role in helping to reduce the significant continuing toll of new HIV infections in the United States. CDC is currently working with partners to ensure safe and effective PrEP use and begin to address key questions about acceptability, access, adherence, behavioral risks, and patient outcomes in community settings.
CDC PrEP Guidance
CDC is leading national efforts to develop comprehensive Public Health Service guidelines for PrEP. Until those more detailed guidelines are available, CDC has developed interim guidance for physicians electing to provide PrEP for HIV prevention among MSM, heterosexually active women and men and people who inject drugs.
In November 2010, the National Institutes of Health (NIH) announced the results of the iPrEx clinical trial, a large, multi-country research study examining PrEP among MSM. The study found that daily oral use of TDF/FTC provided an average of 44% additional protection to MSM who also received a comprehensive package of prevention services that included monthly HIV testing, condom provision, and management of other sexually transmitted infections. The level of protection varied widely depending on how consistently participants used PrEP, with significantly greater levels of protection among those who adhered well to the daily regimen. Among MSM with detectable levels of the medication in their blood, the risk of HIV acquisition was reduced by more than 90 percent.
In July 2011, a CDC study called TDF2, along with a separate trial by the University of Washington (Partners PrEP), provided evidence that a daily oral dose of antiretroviral drugs used to treat HIV infection can reduce HIV acquisition among uninfected adults exposed to the virus through heterosexual sex.
TDF2, conducted in partnership with the Botswana Ministry of Health, found that once-daily TDF/FTC reduced the risk of acquiring HIV infection by 62 percent overall in the study population of uninfected heterosexually-active men and women. Blood level data showed that participants who became infected had far less drug in their blood, compared with matched participants who remained uninfected suggesting that medication adherence is associated with the efficacy of PrEP in preventing HIV infection.
Partners PrEP found that two separate antiretroviral regimens – TDF/FTC in combination and tenofovir alone – when provided to uninfected persons whose partners have HIV infection (sero-discordant couples) significantly reduced HIV acquisition (by 75 percent and 67 percent, respectively). Participants in the TDF/FTC group with detectable levels of the medication experienced a 90 percent reduction in risk for HIV infection; in the tenofovir- only group, the presence of medication in the blood was associated with an 86 percent reduction in risk. CDC co-managed two of the nine sites for this study.
Two other research studies among women, FEM-PrEP and VOICE, found that participants provided PrEP did not experience any protection against HIV. Analyses of blood level data showed that very few women assigned to use the study drugs in either study were actually taking the pills as directed, indicating that lack of adherence was likely the major factor contributing to the lack of effectiveness in these studies.
In June 2013, the Bangkok Tenofovir Study, conducted by CDC, the Bangkok Metropolitan Administration and the Thailand Ministry of Public Health, reported that a once-daily tablet containing tenofovir reduced the risk of acquiring HIV by approximately 49 percent among men and women who inject drugs.
Consistent with prior research, participants who took the medication consistently had higher levels of protection. In an analysis of participants known to be adherent because they were observed taking their medication and had tenofovir detected in their blood, the risk of HIV acquisition was reduced by approximately 74 percent.
No studies conducted to date have identified any significant safety concerns associated with use of daily oral PrEP.
On July 1, 2012, The Dignity for All Students Act (also known as “DASA” or “The Dignity Act”) went into effect. With its 19-year history of supporting schools across Long Island to address and reduce bullying,Long Island Gay and Lesbian Youth (LIGALY)is here to help your school Get DASA Ready!
What is DASA?
The New York State Dignity for All Students Act (DASA) amended State Education Law to legislate that NO student in any public elementary or secondary school shall be subjected to harassment or discrimination by other students or school staff based on actual or perceived sexual orientation, gender, gender identity and/or expression, sex, race, color, weight, national origin, ethnic group, religion, religious practice, or disability.
Why is DASA important?
Harassment and discrimination instills fear in students and leads to high-risk behavior, difficulty concentrating and learning, lower grade point averages, skipping school, and reduced graduation rates. This is particularly evident among gay, lesbian, bisexual, and transgender (GLBT) youth.
- 85% of LGBT youth report being harassed at school because of their sexual orientation and 64% report begin harassed because of their gender identity and/or expression;
- 30% of LGBT students report missing school because of safety concerns;
- The grade point average of students frequently bullied because of their sexual orientation or gender expression is almost half a grade point lower than other students.
LIGALY can help your school Get DASA Ready in order to create safer and more supportive school climates where your students can learn and focus in order to reach their fullest academic and developmental potential, rather than dreading going to school for fear of being harassed.
How can LIGALY help your school get DASA ready?
Since 1993, LIGALY’s Safe Schools Initiative has developed and sustained relationships with more than 100 Long Island school districts by providing the following educational and support services:
K-12 Faculty and Staff Training. Over the past 19 years, LIGALY has learned that most times school personnel want to address anti-LGBT bullying, but simply do not know how. This training provides Educators, Administrators, Faculty, and other staff with the knowledge to better understand LGBT youth and the challenges they face as well as the tools to address, reduce, and prevent anti-LGBT bullying in schools and how to effectively respond to incidents of harassment.
Learn more about K-12 Faculty and Staff Training>> Anti-Bullying Workshops for Students.
LIGALY provides fun, interactive, and age-appropriate workshops in classrooms in grades K-12, which dispel myths and stereotypes, provide accurate information about LGBT people, address LGBT-related bullying, and discuss how bullying of any kind is bad for the entire student body.
Learn more about Anti-Bullying Workshops for Students>> Support for Gay Straight Alliance Clubs.
Research has shown that having a Gay Straight Alliance (GSA) Club in schools leads to more positive experiences for LGBT students, including less victimization and less absenteeism. LIGALY has helped students and educators start and sustain approximately 100 GSA Clubs in middle and high schools across Long Island.
Learn more about Gay Straight Alliance Clubs>>
Each March, LIGALY offers a conference with a variety of powerful anti-bullying workshops that educates over 400 youth, educators and service providers annually in order to bring positive change back to their schools and communities.
Learn more about the Long Island GLBT Conference>>
For more information about how LIGALY can help your school get DASA Ready, email firstname.lastname@example.org or call 631.665.2300 or 516.323.0011