A Pill a Day to Prevent HIV Infection

by

On July 16, 2012, the Food and Drug Administration approved the first drug to reduce the risk of HIV infection for uninfected individuals at high risk of contracting HIV. Truvada (emtricitabine/tenofovir disoproxil fumarate), in combination with safer sex practices, was approved for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV. Approval was based on data from 2 clinical trials involving over 7,200 individuals; Partners Prep and IPREX. These studies demonstrated a substantial reduction in acquisition of HIV with consistent oral use of Truvada.

Cree Gordon, Test Positive Awareness Network

On August 9, 2012, the Centers for Disease Control and Prevention (CDC) released an interim guidance for clinicians considering use of PrEP for prevention of HIV infection in heterosexually active adults. Previous CDC guidance focused on reduction of risk of HIV acquisition among men who have sex with men.

(Credit: Justin Sullivan/Getty Images)

This controversial decision provides additional options for persons at risk of acquiring HIV, such as uninfected individuals in relationships with HIV infected individuals, or high risk individuals such as sex workers who may not be able to navigate protection. Opponents (The AIDS Healthcare Foundation) of this decision believe there is not enough safety and efficacy data to support an indication in women, and are concerned about development of resistance if Truvada is not taken regularly.

We believe this landmark decision is critical in the fight against HIV. Combined with safer sex practices, Truvada is an important addition to the toolkit of HIV prevention technologies. We also support expanded research on how Truvada will be used in real-world settings.

Advertisements

4 Responses to “A Pill a Day to Prevent HIV Infection”

  1. majidshafiq Says:

    Like most other anti-infective agents, Truvada is also known to run a risk of resistance especially if not taken regularly. Unfortunately, some of the “high-risk for HIV” groups of individuals are well-known to be much more likely to be non-adherent to medical advice, including the regular intake of anti-HIV drugs even when diagnosed with HIV. For this reason, HIV treatment experts are often forced to stop medically indicated anti-HIV therapy after thorough discussions with patients and their significant others, since intermittent intake of these medications are medically ineffective on one hand and introduce drug-resistant HIV strains into the community on the other. One would need to keep this issue in mind when administering Truvada for PrEP. In some cases it would be a question of “to do or not to do good to an individual” and in some, it would be that of “to cause or not to cause harm to the public.”

  2. nickseeliger Says:

    Tough call when the implications for individual safety may impact public safety in the long run. However, I feel that in this case the CDC is on point. The more tools available right now to fight this pandemic the better. In general with communicable diseases prevention is paramount. Truvada seems to do just that. This seems to me to be very similar to providing vaccines to high risk groups for other diseases(ie. pneumovax). If we can target prevention now in the most at risk groups I feel this will be a great step in the fight against HIV.

  3. kburns7 Says:

    I definitely agree that this was a landmark decision in the fight against HIV. While opponents are correct in arguing that for Truvada to be effective, it must be taken regularly, I don’t feel that this warrants it not being approved. The decision to prescribe Truvada should occur in the same way the decision to provide any other medication does. It should be at the discretion of the physician, after the physician has seen the patient and had a discussion – or many – with them about various treatment/prevention options to best determine what works in their current situation. This medication will not be prescribed to everyone for prevention of HIV infection, just as other medications are not prescribed to all. It should be a decision based on each individual patient, weighing the risks and benefits of the drug against the other available options. For these reasons, I agree with FDA’s decision to approve Truvada and see it as yet another great tool to be utilized in the fight against HIV.

  4. nmartin2012 Says:

    AIDS advocates have expressed concern that Truvada will create a false sense of security amongst users and promote unsafe sexual behaviour. This could lead to a reduction in condom use and be detrimental to HIV prevention efforts.

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: