Stopping HIV via prevention - update on the Truvada revolution

November 4, 2015 11:08 AM

It's been just over a year since the CDC came out with guidelines for using HIV-drug Truvada as pre-exposure prophylaxis (PrEP) in preventing HIV. Where are we now? VICE created a thoughtful documentary on the topic that interviews Truvada advocates, critics, and HIV researchers. Stopping HIV with the Truvada Revolution : Part 1; Part 2; Part 3

Promising results continue to come in from PrEP trials (plain-language summaries):
Results of PROUD and IPERGAY studies
Partners PrEP Demonstration Project

Is taking PrEP right for you?

Michael Weinstein, the leader of AIDS Healthcare Foundation [AHF] was a staunch critic of PrEP. Recently he seems to have softened his stance:
Reaching common ground on PrEP

An article in the American Journal of Public Health weighs in on Truvada as PrEP.
How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure
"It is essential for science to trump stereotypes and sex-negative messaging in guiding decision-making affecting PrEP access and uptake."

Previously, previously

posted by biggreenplant (6 comments total)

Also worth noting: PEP (Post-Exposure Prophylaxis) is less effective than PrEP, but it is effective.

I mentioned this recently in another thread, but if you think you have been exposed to HIV, go to an emergency room immediately -- call 911 if that's the only way you can get to an ER in a timely manner.

When administered in a timely manner, PEP has been shown to be reasonably effective at blocking transmission.

I'm seriously pissed that there hasn't been a huge public-awareness campaign about PEP and PrEP -- concern-trolling over PrEP is just as bad as abstinence-only sex education. If people don't know about PEP and PrEP, they can't possibly make intelligent decisions about their risk-prevention strategies.
posted by schmod at 11:38 AM on November 4, 2015 [11 favorites]

I recently stopped seeing a good friend (not sure what the long-term prognosis is) because when I told her about PrEP, thinking she'd agree with me that it is an amazing thing, it caused her to launch into a homophobic rant about irresponsible sex & the pleasures of monogamy, including echoes of many of the classics: people should have to take responsibility for the consequences of the sex they have, AIDS made the gay male community "grow up," it was OK to have casual sex with strange men when there was no gay male community/acceptance, etc. She is a pro-choice lesbian, so I think her reaction speaks to something about how deep-seated cultural fears of sexual license are.

I was thrilled to learn about PrEP earlier this year, and, like schmod, think it needs to be promoted more. "I'm seriously pissed that there hasn't been a huge public-awareness campaign about PEP and PrEP -- concern-trolling over PrEP is just as bad as abstinence-only sex education. If people don't know about PEP and PrEP, they can't possibly make intelligent decisions about their risk-prevention strategies." Exactly.
posted by not that girl at 2:41 PM on November 4, 2015 [3 favorites]

I am a Truvada-as-PrEP user and the pushback against it is shocking to me.
posted by sevenyearlurk at 5:28 PM on November 4, 2015 [3 favorites]

PrEP sounds like a hugely good idea to me, to the extent where it might actually largely eliminate HIV transmission in many higher-risk groups. The only moral problem I have with it is that as I understand, it's necessary to take it regularly (you can't just take it the day before a sexual encounter or whatever), and it's expensive, so it'll only really help fairly well-off people, and leave those with no resources in the lurch, as has happened so often before.

How long will it be before these drugs might be available as generics? Is it likely the cost will then go down? It almost seems to me like it should be something government might want to consider allocating funds to as a general HIV/AIDS fighting measure, at the bulk prices governments should be able to get, it might well give better value for money than many other measures.
posted by Joakim Ziegler at 11:46 PM on November 4, 2015

A lot of key HIV drugs are coming off-patent within the next few years. The patents for the two drugs in Truvada expire in 2017, I think, although it seems there may be a separate patent for manufacturing them together in a single pill. This article discusses how the availability of affordable generics may impact HIV treatment in the near future.
posted by sevenyearlurk at 9:49 AM on November 5, 2015 [1 favorite]

Not sure how I even missed this thread but yay, this thread and yay PrEP and as of next month all planned Parenthoods in L.A. County will be offering PrEP and PEP!
posted by Sophie1 at 3:36 PM on December 1, 2015