FDA Approves Drug That Prevents Transmission of HIV

[redbones111]

This was in the local paper, an excerpt:

Milestone reached in 30-year AIDS epidemic as Food and Drug Administration approves Truvada, the first drug that prevents transmission of HIV

The 30-year AIDS epidemic reached a once-unseen milestone Monday as the feds approved the first drug that prevents the transmission of HIV.

The Food and Drug Administration okayed Truvada, calling the little blue pill “an important milestone” in the struggle to curb a disease once considered a killer.

The FDA’s decision comes less than two weeks after the agency approved the first over-the-counter HIV home test.

And such testing is key, activists said, because too many New Yorkers have the virus that causes AIDS yet don’t know it.

As a result, the approval of Truvada, manufactured by Gilead Sciences, was greeted with some apprehension.

“We celebrate Truvada, [but] we still want to tell people to be sure they use all the tools . . . to prevent HIV,” said Marjorie Hill, CEO of the Gay Men’s Health Crisis. “The reality is this is one good tool, but it’s only one tool. We still need education, education, education.”

Article here: Daily News

I'm happy about this advancement, but I worry that this will give the irresponsible a free pass to be even more reckless. Thoughts?

 

[tonka]

I read that a years dose of Truvada will cost $13,000 (here in the states). Will insurance pay for that?
The at home HIV test might have a wider impact. It could be a first step for someone who doesn't want anyone to know.

 

[jeansGuyOZ]

It's unfortunate that the article uses the word "prevents". That implies that one can can happily have sex of any kind with an HIV-infiected person, without using condoms or any other protection.

Perusal of the article reveals that it cuts the risk by between 42% and 75%, depending on what demographic you are talking about. That's not my definition of "prevent". "Inhibit" would have been a better word. I know there is such a thing as journalistic licence, but I think the wording of the sub-heading borders on irresponsible.

Anyway, although it's a huge breakthrough, there are some very obvious problems. It's expensive. That means that someone who does not have HIV and wants to take Truvada as a preventative is going to need heavy encouragement, via the drug being either free or heavily subsidised. It also has potential unpleasant side effects, like all HIV drugs. Then, after all that, it still offers only up to 75% protection anyway, so if the person is serious enough about the dangers of HIV to take the drug, then they are going to also use condoms, avoid sharing needles, etc etc. Given that, they might well ask, if they are being so careful as to do all those things, why should they take the drug at all? After all, condoms are known to be highly effective.

The most cost effective way to use the drug, it seems to me, would be to supply it free of charge to drug addicts, who know they shouldn't share needles but are nevertheless likely to throw caution to the wind when they are in dire need of their "fix". Even then, it would have to be non-compulsory, given the potential side effects.

I hate to say it, but unless the 75% figure can be improved to something like 99%, I don't see this making a huge amount of difference in the number of HIV cases.

 

[777]

The most cost effective way to use the drug, it seems to me, would be to supply it free of charge to drug addicts, who know they shouldn't share needles but are nevertheless likely to throw caution to the wind when they are in dire need of their "fix". Even then, it would have to be non-compulsory, given the potential side effects.

That's an excellent point, it might make difference in those situations. Also I was thinking of couples where the other one has HIV and the other doesn't. But I agree with you, it's probably not going to make much difference otherwise.

 

[tonka]

It might really help with a couple trying to get pregnant if the man is positive and the woman negetive.

 

[jeansGuyOZ]

It might really help with a couple trying to get pregnant if the man is positive and the woman negetive.

You know what? That scenario never even entered my head. Just shows that I can't help looking at everything from a gay point of view.

 

[slimjim]

The claim for it is that it reduces the risk of contracting HIV. Presuming that it also reduces the incidence of people becoming "carriers" then it would be very helpful for all sex-workers, rentboys/prostitutes/escorts, as it should seriously reduce the spreading of the disease. But given the cost of it and the fact that to be effective it has to be taken every day it seems unlikely that this would happen.

 

[topdog]

It's unfortunate that the article uses the word "prevents". That implies that one can can happily have sex of any kind with an HIV-infiected person, without using condoms or any other protection.

Perusal of the article reveals that it cuts the risk by between 42% and 75%, depending on what demographic you are talking about. That's not my definition of "prevent"...

The study was published a year and a half ago. The risk % reported in the press is misleading because, as usual, most reports skim off only the most superficial information. I posted more details here when the study came out in 2010.

The first thing to note is that in every study all participants are instructed to always use condoms. So the results are for Truvada plus condom use. But the results reflect real world outcomes. Not everyone actually used condoms all the time. (The use and non-use of condoms was the same in both groups.)

The reason for the varying success rates is because not everyone took the drug regularly as prescribed. If they were to limit the results to only those who took the drug everyday, the success rate would be over 90%. USA Today has a good summary article. The LA Times has good coverage on the details of the study.

So no one is proposing Truvada as an alternative to using condoms. Its value is in how more effective condoms +Truvada is than condoms alone.

It is expensive, though. You could probably get insurance to pay for a specified treatment for a limited time. But a lifetime of preventative use - probably not. Unless you want your doctor to say he is prescribing it because you have HIV.