I saw this interesting article on New York Times, keep reading... Federal health officials are urging hundreds of thousands of healthy people at high risk of contracting AIDS to take a pill every day to protect themselves from the virus that causes it.
The recommendation could help reduce the stubbornly high number of infections, which has held steady at 50,000 new infections a year in the United States. But the pill carries risks that must be addressed as well.
The drug, made by Gilead Sciences and known as Truvada, contains two antiviral drugs that have been used for a decade in combination with other drugs to treat people already infected with H.I.V., the virus that causes AIDS. Two years ago the Food and Drug Administration approved it for a radically different purpose — to prevent disease in people who have not yet been infected. When taken every day, the pill can be extremely effective; it protected 99 percent of the gay men in one study.
In guidelines issued Wednesday by the Centers for Disease Control and Prevention, the pill is recommended for high-risk groups like gay men who have sex with multiple partners, heterosexuals who have sex with high-risk partners such as intravenous drug users, people in sexual relationships with someone known to be infected, prostitutes and anyone who shares needles. The pill is supposed to be used along with condoms and other safe sex practices to provide added protection, but many men could shun condoms knowing that this option is available.
The dangers of that behavioral change are worrisome. Unprotected sex could lead to higher rates of syphilis, gonorrhea and other sexually transmitted diseases, as well as unwanted pregnancies. If people fail to take their pill every day, as many will, they will increase the risk of developing and spreading a resistant strain of the virus.
Truvada is also expensive — about $13,000 a year — and usage could soar from fewer than 10,000 prescriptions a year to perhaps 500,000 a year. Most insurers and state Medicaid programs already cover the drug so patients should be able to afford it, but the cumulative cost could cause financial strains for public and private programs.
Even so, the potential benefits of preventing infections outweigh the risks, especially if steps are taken to minimize the risks. Before starting on Truvada, patients should have an H.I.V. test to make sure they are not already infected, in which case they should be taking three drugs. They should be retested every three months to determine whether they have become infected or have developed side effects or sexually transmitted diseases.
The new approach, if carried out with care, could be a big step forward in curbing the toll from AIDS.
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