100 Percent Efficacy

That’s the effectiveness of Truvada in preventing HIV infection in the latest large study just unveiled at the AIDS conference in Melbourne:

PrEP had no significant efficacy in people who took fewer than two doses a week. However, the efficacy of PrEP was 84% in people who took 2-3 doses a week – there was only one infection in this group – and no infections at all were seen in people taking at least four doses a week. This 100% efficacy translates into a minimum efficacy of 86% if the statistical uncertainty of the result is taken into account.

Did they all throw condoms away?

The study found absolutely no “sexual risk compensation” among participants—that is, those taking PrEP did not abandon other forms of protection, namely condoms. That data was self-reported. But researchers also tested participants for syphilis, another marker of sexually risky behavior, and found that those on PrEP were no more likely to carry the sexually transmitted infection than those not taking the drug.

The debate in the gay community is not really a debate at this point; it’s a function of the deep difficulty of psychologically navigating from a way of life dominated by plague to a normal way of life. It will take time. But the potential of this drug, combined with condoms and cocktail therapy for the infected, is nothing less than the eradication of HIV among gay men in our lifetimes.