Truvada And Women

It’s been a telling facet of the debate so far that the potential for the drug among women has been absent. This is often the case with AIDS drugs – the gay white rich men pioneer the treatments and only then do others get in on the action. But in some ways, it seems to me, the liberating potential of the anti-HIV drug is even greater for many women, especially in the developing world. A huge factor in their risk profile is the fact that their sexual partners often refuse to use condoms, and, in patriarchal societies, women are put at risk. Truvada might help shift that power differential. Two steps that could speed that process:

WHO needs to quickly issue guidance on PrEP for all of the populations that can benefit. truvadaThe data are strong enough to warrant this move, as the U.S. Centers for Disease Control and Prevention recently showed with its guidance that recommended that doctors consider oral PrEP for anyone at high risk of HIV infection … Gilead Sciences Inc., the maker of Truvada, needs [also] to move swiftly to secure regulatory approval in countries where PrEP is most needed. This starts with the countries that hosted clinical trials, where, tragically, PrEP is now out of reach. In two of those countries, South Africa and Thailand, Gilead recently filed for approval. This is an important and welcome step but the process needs to happen much faster and in more places. That requires both more aggressive efforts by Gilead and the willingness of national regulatory authorities to quickly review and approve the company’s applications.

The sooner the better. Update from a reader:

As a biomedical journalist, I have written about HIV for 20+ years. The US is the only place where regulators have approved a Truvada indication for PrEP; that label indication is not approved in Africa, Europe, even Canada. So it is appropriate to deal with PrEP in the context of the US. The CDC estimates that women constitute 20% of new infections and 24% of persons living with HIV in the US. The only data we have on who was prescribed PrEP was presented at ICAAC last September. In the first year after approval, 1774 persons started PrEP; 48% were women.

So it is decidedly NOT true that rich white gay men have been getting PrEP at the expense of other less favored socio-demographics.