Is an ounce of prevention worth a pound of cure? The U.S. Centers for Disease Control and Prevention (CDC) hopes so, although in this case it is a prevention pill in lieu of a non-existent AIDS or HIV cure. The CDC is recommending that those at high risk for contracting HIV take medicine to cut their risk of getting the virus.
While no cure for HIV or AIDS has been found, there are medicines that are highly effective at blocking transmission of the virus when used consistently. Taking prescriptions as preventative measures, called pre-exposure prophylaxis or PrEP, has reduced the HIV infection rates in tests by up to 90 percent, according to the CDC.
CDC director Dr. Tom Frieden noted that HIV infection is preventable today, but approximately 50,000 people get HIV infections annually in the U.S. He added, “PrEP, used along with other prevention strategies, has the potential to help at-risk individuals protect themselves and reduce new HIV infections.”
The new CDC guidelines say to use a drug called Truvada, as the PrEP, along with safe sex practices. They recommend the PrEP regimen by used by:
- Anyone in an ongoing relationship with someone who is infected with HIV;
- Any gay or bisexual man who, in the past six months, had sex without a condom or was diagnosed with a sexually transmitted disease, and is not in a mutually monogamous relationship;
- Someone heterosexual who does not consistently use condoms when having sex with people at high risk for HIV (injection drug users or bisexual male partners) and is also not involved with an HIV-negative person in a mutually monogamous relationship;
- Those who injected illegal drugs in the last six months, shared needles for injecting drugs, or have been in a drug abuse program.
The PrEP pills need to be taken regularly so the level of protection from PrEP does not drop, the CDC cautioned. That is why they still recommend safe sex practices, like condoms.
PrEP must be used with other proven prevention measures, like practicing safe sex, getting tested for STDs regularly, as well as knowing your partner’s HIV status, according to Dr. Michael Mullen, a professor of medicine and infectious diseases with the Icahn School of Medicine at New York City’s Mount Sinai Hospital.
There is concern that convincing gay men and others to take a daily pill may prove a tough sell to many doctors and patients. Leading AIDS organizations support the regimen. Among the concerns expressed is that gay men (or drug users) may not have told their doctors about their personal lives.
Some doctors express concern that people will not remember to take Truvada daily, and failure to do so will undermines its effectiveness. The same doctors, however, do not question whether people will take daily pills for their cholesterol or blood pressure.
AIDS expert Dr. Albert Liu, with the San Francisco Department of Public Health, served as the lead researcher in a three-city demonstration project for the regimen. He indicated that during their tests, adherence was not perfect, but almost 98 percent of the participants had the drug in their blood when tested. Liu found the Truvada pill effective as a prevention measure in lieu of the yet-to-be found permanent cure.
By Dyanne Weiss