Pop a Pill and Prevent HIV?

Researchers on the HIV front discovered that a widely-used medication used to treat HIV disease (Truvada) can also be effective in helping to prevent HIV infection. Maybe you've heard the rumors, read the stories. This is huge news in the HIV prevention and research world. In fact, Time Magazine referred to this as the #1 Medical Breakthrough of 2010.

Yet, for the average person looking to be safe and protect themselves and their partners from HIV, this may be nothing more than a dangerous and expensive mirage.

Researchers studied 2,499 gay and bisexual men in six countries, half of whom took Truvada on a daily basis and half took a placebo. They found that among the men who were on Truvada, 44 percent had a reduction in HIV infection rates. For those who were most compliant with taking the medication (those who took it consistently each day without any missed doses at all), they found a 73 percent reduction in HIV infections.

(I couldn't help but wonder as I read this: they stood by as men engaged in risky behavior for purpose of research? That's a whole other discussion, and clearly I'm not a researcher so I will refrain from further comment. However as a Philosophy/Medical Ethics major in college I couldn't resist at least asking the question. I digress...)

From a medical standpoint, this is truly remarkable news in HIV research and prevention. It shows just how far we have advanced in the prevention of this virus. The power of this small blue pill can be viewed as a "turning point" in this epidemic. It allows for further study and perhaps can open the door to more effective treatment and prevention options. Plus it provides an invigorated sense of promise and hope. Hope that one day we may just witness a cure to this devastating disease.

As Mitchell Warren, director of the AIDS Vaccine Advocacy Coalition, said: "I don't know of a day where so many pieces are beginning to align for HIV prevention and treatment, and frankly with a view to ending the epidemic. This is an incredibly opportune moment and we have to be sure we seize it." Even President Obama expressed his hope at us entering into a "new era of HIV prevention."

That's the good news. The not so good news is that this is not a quick, easy, or even cost-effective prevention measure. Notice the greatest HIV infection reduction rates were experienced among those who took the pill without fail each day. For many people, it's incredibly difficult to be on point 100% of the time. Compliance is a serious issue and can drastically affect the potential of this medication, as a treatment measure and clearly as a prevention option. Then there's the expense. Truvada is not cheap, potentially costing anywhere from $5,000 to $14,000 a year. That's rather steep, especially if it's not providing 100% protection.

Any advanced prevention option is promising news. Especially among men who have sex with men (MSM), a group that has seen a surge in HIV infection rates. For those MSMs who are at an even higher risk of contracting HIV due to even more complicated factors, including intimate partner violence, rape, and homelessness among others, this could be a life-saving option. Those without much power and control may see condom negotiation as as a far off, unobtainable dream. A pill like this provides some sense of control and protection. That is a huge advance.

The real world is so much more complicated than a controlled study. There are countless additional factors involved that influence a person's HIV risk at any given moment. Because of this, condoms are still the most effective option to help prevent sexual transmission of HIV - outside of the big A-word (Abstinence), of course. Plus, let’s not forget that there are other sexually transmitted diseases (STDs) out there. It seems the ideal would be to further develop medical prevention measures that could be used in conjunction with condoms.

As Dr. Robert Frascino, "Dr. Bob", HIV Physician Specialist and Community Forum Expert at TheBody.com, asserts: "Condoms remain absolutely essential. Truvada does 'lessen' the risk of HIV transmission, but it certainly doesn't completely eliminate it." So please, don't abandon your condoms or use them as water balloons. Well, some can be used for silly condom games, but save plenty for intimate games.

Photo Credit: socialpacks.com http://gayrights.change.org