This headline is a lie.

Shadiness around “PrEP efficacy”

Check out this article! I’ve been asking where the “PrEP is 99% effective” claim is really coming from, and it seems that there has been, at long last, a study that claims to prove this figure is true. Here it is:

New study confirms HIV preventive drug PrEP to be 99 per cent effective

There is only one problem. The “new study,” referred to in the headline, is the so-called British “Impact Trial,” and the “efficacy of PrEP” that they calculated pursuant to the study was not 99%. It was 86%.

Now, you might still be impressed with the 86% figure, as it represents a nontrivial increase from, say, the 43% estimate from the iPrex trial. Never mind that the analysis of iPrex managed to extrapolate the 43% out to the 99% that they assumed would occur given perfect adherence. Never mind that these statistical shenanigans are being used constantly. There are some oddities about the Impact Trial in both design and analysis, and I hope to have an in-depth examination of this study by the weekend. I might throw in iPrex too for fun and comparison. One thing I would like to make very clear is that what the Impact Trial did was not an actual “clinical trial” in the scientific sense; it was more of a retrospective study, whose results are typically considered inferior to those of controlled trials. However, as we know, true controlled trials are considered “unethical” in AIDS research, so the information we are going to get is necessarily less reliable than it could be.

Another thing that perplexes not only me but other mathematicians is that their definition of “efficacy” is unclear. Over what period of time? How many encounters? At even 86%, you would think that over time, this would translate to a lot of “seroconversions.” As I’ve said before, PrEP ought to be darn near perfect to justify such aggressive marketing that comes dangerously close to coercion. Here’s a thought experiment. Would you feel okay having an elective surgical procedure that had a 14% chance of failing?

But the problem isn’t really the number that they come up with; the problem is that the headline linked above is a blatant lie. Here’s the opening:

A new study has found a preventive HIV drug to be highly effective. 

The study, called “the PrEP (Pre-Exposure Prophylaxes) Impact Trial”, was conducted by the UK Health Security Agency (UKHSA), with Chelsea and Westminster Hospital NHS Foundation Trust. 

[…]

According to the study, PrEP, a drug that stops HIV from infecting the body has now been proven to be highly effective in the “real world” as a preventative treatment. 

It is unclear where they got the 99% cited in the headline. It takes more than half the article for the “truth” to come out.

The study found that the use of PrEP reduced the chances of getting infected with HIV by around 86 per cent when used in everyday life, taking into consideration the account of inconsistent or incorrect use. On the other hand, clinical trials suggested that the medication is 99 per cent effective. 

Ah, there it is. “Clinical trials suggested” that the medication is 99 per cent effective. Give me one single clinical trial of PrEP that DEMONSTRATES—not infers, demonstrates—such a high efficacy rate for PrEP. I’ve been waiting for a while.

This is the game being played. It has always been the game. If you’re Gen X (like I am) or older you probably remember AZT being touted as a miracle drug in the mainstream media. You probably also remember the protease inhibitors being lauded as having ended AIDS, despite causing liver failure, lipodystrophy, and cardiovascular disease in many patients. So what is going to happen with PrEP? Here’s a hint: Truvada is the drug being used for PrEP. Truvada has failed already. And the game gets a whole lot more sinister when “AIDS journalists” and “science journalists” publish articles like this that use blatantly deceptive language in the title. How many more lies are we being told? And why does no one seem to even care?

Moral of the story: Headlines are click bait, but when people don’t even bother to click, and sometimes even when they do, they are very easy to deceive.

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