HIV Treatment As HIV Protection

Jun 13 2013 @ 3:37pm

I’m a broken record on this, but the second truly important thing about HIV meds (after saving your life if you’re infected) is that they can also save your life and protect your health when you’re not infected. The last group to be tested for pharmaceutical prophylaxis is IV drug users, and they too saw remarkable results:

Drug-injecting addicts who took a daily antiretroviral pill were half as likely to become infected with H.I.V. as those who did not, a major new study has found, providing the final piece of evidence that such treatments can prevent AIDS in every group at risk … According to the C.D.C., when study results are adjusted to include only participants who took their pills most of the time, the protective effects are 92 percent for gay men, nearly 90 percent for couples in which only one partner is infected, 84 percent for heterosexual men and women, and about 70 percent for drug injectors.

AIDS and HIV are no longer terrifying for young gay men – for the good reason that the impact of the disease is so much less devastating than it once was. But it remains a chronic disease, the medications are not without serious side-effects, and infection rates remain stubbornly high. It’s not over, and it should be.

TenofovirMy view is that every doctor who treats a sexually active gay man should put him on a daily retroviral in the same way you might prescribe a daily anti-cholesterol drug for someone with high cholesterol. If 92 percent of gay men can avoid infection this way, then we could truly turn the tide.This is the equivalent of Plan B for pregnant women – except it’s taken every day and prevents infection, rather than trying to contain HIV once the virus has gotten inside.

Using the old tactics of fear and sexual shaming simply will not – does not – work. Men will have sex with other men, period. It’s about as predictable as cold in the winter and warmth in the summer (maybe more predictable these days). The cost is a fraction of what a full anti-retroviral regimen would be after infection.

So what are we waiting for? Unless to get past the stigma that gay sex is something you should keep as scary as possible? And in my view, these pills should also be over the counter. If we really want to bring infection rates down, there is no reason not to use one the most effective weapons we have. Could it generate HIV-resistance if taken irregularly? Not if you don’t have the virus in the first place. Yes, getting people to take this regularly and properly may be a struggle. But if we can get people to take an aspirin today (one of the best and simplest things you can do for your health), why not this?