Truvada as PrEP?

An FDA panel has recently voted to recommend the use of the antiviral drug Truvada as the first medication to prevent HIV or PrEP (pre-exposure prophylaxis). However there is a great deal of debate about whether or not Truvada will have the benefits its makers promise.

Truvada may be as effective as condoms at stopping the spread of HIV.

Several studies have been done to evaluate how well Truvada prevents HIV infection. The studies found that taking Truvada everyday reduced HIV infections by around 75%. However, if the pill is not taken every day, if it is missed even once a month, Truvada will only reduce infection rates by 44%. In comparison, condoms reduce HIV infections by around 80% when used appropriately. Condoms and Truvada used together may provide higher rates of protection than when used separately.

Unfortunately, Truvada is extremely expensive. One months treatment costs over $1000.While for many people this cost would be covered by health insurance, this would add a significant strain to the over burdened health insurance system in the US, and price pretty much guarantees that anyone who cannot afford health insurance will also not be able to afford Truvada as PrEP.

HIV/AIDS experts and advocates have mixed views on using Truvada to prevent HIV. Some fully support it, believing that anything which can help slow the epidemic is a welcome thing. Others feel that a medication with is no more effective than condoms, while costing hundreds of times as much, is not worth pursuing and the money that would pay for Truvada should instead go towards other prevention programs. A few fear that the low effectiveness when not taken every day will lead to new strains of drug resistant HIV. Several doctors have suggested that Truvada could be beneficial in limited circumstances where condoms are not an option, such as when a couple with one person who is HIV positive is trying to get pregnancy.

Probably the biggest fear among those who oppose Truvada’s use as PrEP, is that people who at high risk for HIV will become complacent, believing themselves protected. This critics say that taking Truvada will encourage people at high risk for HIV to engage in more frequent risky behaviors, to stop using condoms, and basically to believe that they are fully protected.

Truvada has the potential to be a useful tool in the fight against HIV/AIDS, and like any tool it is only as effective as the way it is used. If Truvada is approved by the FDA, it will be up to all of us, people with HIV/AIDS, HIV/AIDS advocates, doctors and people at risk of HIV/AIDS, to make sure this tool is used effectively. If all of us work together to make sure that Truvada is used in the most effective way possible, then we will some new progress in the fight against HIV/AIDS.

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