HIV, PrEP & Emory

When HIV Prevention Treatment Meets Modern Technology

If Emory University had to name its top achievements throughout the last two decades, the discovery of HIV antiretroviral drugs is no doubt on its list, which was invented by three Emory researchers in the 90s and is currently used by more than 90 percent of HIV patients nationwide. To this day, the dedication to fight HIV is well-maintained within the Emory community, and Aaron Siegler, PhD, MHS and associate professor in public health, is one of the passionate scientists who seek to reduce the impact of HIV on public health.

The medication Truvada, which includes an HIV retroviral, emtricitabine, developed at Emory, was first approved to treat HIV positive individuals by reducing their viral load. In 2012, the FDA approved Truvada for pre-exposure prophylaxis (PrEP), a prevention treatment for people at risk of HIV infection. PrEP is an effective method to prevent people from acquiring HIV, but it requires strict adherence to a daily schedule – people often find it hard to follow the schedule over a long period of time. Furthermore, individuals on PrEP have to go to local clinics for quarterly checkups to screen for sexually transmitted infections and monitor kidney function. The frequent clinical visits are a huge time burden on patients, especially for populations most at risk for HIV infection.

Pill with "PrEP" on it. The word HIV in the background.

Siegler and his colleague, Patrick Sullivan, MD, DVM, professor in public health, have developed a way to modernize the screening process, alleviating the burden on patients. PrEP@Home is a system to allow individuals on PrEP to perform many of their required screenings at home, without the need to visit clinics four times a year. With a subscription of PrEP@Home, the home-care kit will be shipped directly to the patient's door to collect samples and thus saves time for in-person clinics. The home-based process is a win-win situation for both the patient and clinician. For patients, PrEP@Home makes it easier to adhere to the required screening schedule; for clinics, PrEP@Home allows for better allocation of their faculty and facilities resources.

A survey conducted by Siegler's team shows positive results in a pilot study, with over 85% of participants indicating they would prefer PrEP@Home to the standard clinic visits. The overwhelmingly positive results may uncover a more important factor of why people struggle to stay on PrEP. There is a substantial amount of misconceptions toward the PrEP medications. For example, some may assume that people on PrEP are highly sexually active. Such social stigma is obviously inaccurate, but it still creates barriers for people who might benefit from PrEP treatment. PrEP@Home gives patients more agency over their healthcare and helps alleviate the social pressure. Siegler predicted that by increasing the accessibility of PrEP, his PrEP@Home system could also become a powerful tool to destigmatize HIV. The antiretroviral drugs developed at Emory are one half of the strategy to reduce HIV infections. "As health scientists, it is our job to give people, as many as we can, the tools to take care of the other half," said Siegler.

Bottles of pills

From a public health viewpoint, PrEP is undoubtedly a "powerful force for good;" but from a societal viewpoint, it can also be a powerful force to overcome HIV stigma. "This project is a great example of innovative technology with a real social benefit. PrEP@Home increases access to an effective preventive treatment for HIV, and does it in a way that empowers patients," said Mark Coburn, director in Emory's Office of Technology Transfer. Siegler's team has been working hard alongside a design firm on polishing the PrEP@Home kit along with accompanying mobile apps to encourage patient adherence. A video (Emory University: Prep at Home) shows a preview of the simple, compact, and efficient product of PrEP@Home, and we look forward to seeing the final products on the market.

TechIDs: 17100, 18169

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