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ldoughty | 7 months ago

"Lies, ** lies, and statistics"

There was one study that saw 0 participants who contracted HIV during the trial according to the data on the FDA PDF [0]. Was 2,000 participants in Africa who were identified as potentially at risk, aged 16-25.

> YEZTUGO demonstrated superiority with a 100% reduction in the risk of incident HIV-1 infection over TRUVADA (Table 13).

~2,000 given YEZTUGO with 0 infections by the end. ~1,000 given TRUVADA with 16 infections by the end.

Now, this is a great study result if accurate. Substantially better. However, 100% protection is misleading clickbait article. The company does not claim to be 100% effective anywhere I can see... and at best they lifted this statement from this study to use as clickbait.

0: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/22...

discuss

order

dr_test|7 months ago

Yeah, it's not 100% protection in all studies. One study did have no participants contract aids which is fantastic and would be one data point for 100% prevention.

Another had 2 participants contract HIV out of about 2000 "Person-years". This was compared to another HIV treatment where 9 people contracted HIV (with only 1k "person-years" in that cohort). This equated to 89% reduction in HIV contraction compared to the other PrEP drug.

And that IS a fantastic result and if everyone could take this we'd probably be in a great spot HIV wise. ~90% improvement over current PrEP is great, and it's way easier to take and not mess up.

[1] https://www.askgileadmedical.com/len4prep/understanding/#stu...

kstrauser|7 months ago

What’s a typical rate for infections per person-year among people not using these precautions? For those who don’t know follow the epidemiology here, how good effective are the older drugs compared to not taking them?

Having grown up when AIDS was peaking, the idea of this scourge preventable and treatable feels damn near like sci-fi, and I’m thrilled at the progress we’ve made.

pitpatagain|7 months ago

I think it's pretty clear that being easier to take and not mess up is the reason for the difference in statistical effectiveness. The reason for lower numbers for effectiveness of daily oral Truvada prep is primarily measuring differences in adherence.

MostlyStable|7 months ago

I'd be interested in a modeling study looking at the equilibrium infection rate, assuming everyone was on the drug, but otherwise did not change their behavior with regards to risky sex (or maybe even under a few scenarios of increased risky behavior from risk compensation [0]. You don't actually need 100% protection for the longterm equilibrium to be eradication of HIV (that's the whole idea of herd immunity).

How long would it take for a drug with this level of protection to result in ~no cases of HIV? What level of adoption would it require?

[0] https://en.wikipedia.org/wiki/Risk_compensation

levocardia|7 months ago

A good use case for the "rule of 3":

>if a certain event did not occur in a sample with n subjects, the interval from 0 to 3/n is a 95% confidence interval for the rate of occurrences in the population.