Eric Sasson wants more attention paid to “PrEP, or Pre-Exposure Prophylaxis, arguably the biggest breakthrough in HIV prevention medication to come out in the last two years.” He’s dead right. HIV-negative men using PrEP are much, much less likely to get infected, and yet there has been no rush to get this news across or to capitalize … Continue reading The Anti-HIV Pill
A reader writes: I read your piece on providing antiretrovirals to at-risk groups and was struck by the exclusion of a significantly large group who literally share your pain: African Americans, especially African-American women. There’s a legitimate argument that sexually active African-American women should be prescribed antiretros by their physicians too. New infection estimates for 2010 by the CDC … Continue reading HIV Treatment As HIV Protection, Ctd
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 … Continue reading HIV Treatment As HIV Protection
A reader writes:
I'm a loyal reader and a grad student in public health with an interest in HIV/AIDS, so your posts on Truvada prophylaxis caught my attention. Good news? Yes. Breakthrough? Not so fast. First off, the 44 percent figure is the important one – not 90 percent – because what really matters is how well the drug works in real life. That a large percentage of the participants in this study still didn't take the pills regularly despite having better-than-average medical attention is a serious problem. Also, all study participants received HIV testing, safe sex counseling, condoms, and treatment for STIs during the study. Who knows whether the effect would be as strong with people not receiving all those other protective services – could be higher or lower.
But the biggest red flag to me is behavioral disinhibition, the idea that people act differently when they believe their risk is lower.
[Taking the pill is] a smaller protective effect than using a condom all the time, of course. The thing is, we know that people aren't good at using condoms all the time. And what these study results show us is that people aren't very good at taking a pill every day, either, though they are keen to tell researchers that they do. One of the most striking things about the results was the mismatch between self-reported pill taking and measured levels of active drugs in people´s bodies.
Her second fear:
A reader writes:
There are other realms in which Truvada is being used for HIV prophylaxis. I'm a dental student who sees patients daily for treatment. This past summer, I accidentally stuck myself with a needle that had been used with an HIV-positive patient.
Dozens of readers this year added their very personal perspectives to the breakthrough drug Truvada and the baffling resistance to it by many gay activists. Read the whole discussion thread here. Below are a few previously unaired emails to add to the mix: Most of the coverage of Truvada has been about the idea of “Truvada whores” … Continue reading The Best Threads Of 2014: “Why Aren’t Gay Men On The Pill?”
Apr 9, 2014 @ 12:31pm The Associated Press – about as mainstream as you can get – has an article out this week about a very marginalized medication: It’s the Truvada conundrum: A drug hailed as a lifesaver for many people infected by HIV is at the heart of a rancorous debate among gay men, … Continue reading Why Aren’t Gay Men On The Pill?
Another round of emails focuses on the high cost of PrEP drugs like Truvada: I was just turning 30 when the AIDS epidemic struck. I spent the next 13 or so years caring for, then burying, my friends and loved ones. Somehow a few friends and I escaped infection; I don’t know how. In the intervening years, … Continue reading Why Aren’t Gay Men On The Pill? Ctd
A reader writes: You surprised me when you wrote, “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.” Aside from the cost, prophylactic HIV medications do have side effects, don’t they? In … Continue reading Dissents Of The Day