Truvada - not the HIV miracle preventive it seems

Research shows progress in yet another HIV-preventive medication; Truvada is a combination of tenofovir and emtricitabine (already used in treatment to prevent AIDS from setting in after an HIV transmission). However, this chemical condom, could be a dangerous drug to begin sharing with the public.

Trials with Truvada raise the idea that "one single pill once a day, totally available in the pharmacy for patients, can be used to prevent transmission by any mode anywhere in the world," according to J. Victor Garcia-Martinez, the study's author. However, there is no guarantee that Truvada will protect everyone all the time. While Garcia-Martinez and colleagues learned previously that this drug prevents vaginal transmission of HIV, this study clarified that an HIV infection could be prevented during anal sex and intravenously. Of the 17 mice "vaccinated," only one became infected. The study reports that "by contrast, several mice that did not take Truvada became infected."

Why do I believe that Truvada could be a dangerous drug?

It's expensive! Costing hundreds of dollars a month, many people in the societal groups needing specific protection would be unable to afford the medication. I can see situations where groups of people "go-in" for months worth of protection and share it. By not using the medication properly, the patient has the chance of contracting HIV and HIV has a chance of further mutation.

Sexual risks could increase! I wonder if people who can afford the hundreds of dollars a month would prefer to take this medication and have risky sex than to prevent the transmission and not take the medication. While I am sure that the percentage would be small, it is a valid concern.

The side effects! The list of side effects connected to Truvada is so intense, I'm sending you to Drugs.com to read them instead of listing them here. The side effects are often so severe, people would not take the medication regularly to prevent feeling ill.

While the idea is valuable and definitely has positives, I believe that more research needs to be done before this medication is marketed towards those in need of more drastic preventive measures. Without a guarantee of perfect, or near-perfect

What is your opinion? Should Truvada be marketed towards populations who need it?

Should this kind of medication be covered by insurance or should it be on the patient to pay for it?

How do you think sexual risks would change once a patient began taking this medication?

I encourage you to take this controversial subject to other HIV health activists and see what they think. rom what I can see now, very few people are willing to speak out about Truvada. Will you be one? Talk about the positives and consequences that surround preventing HIV with a daily oral medication.

Tags: AIDS, AIDS news, HIV, HIV news, HIV preventive, HIV/AIDS, medication, preventive medication

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Comment by Marie on January 29, 2010 at 1:53pm: What an interesting post, Sarah!

I was unaware that Truvada was being tested in this way - I don't know of any other drug that's being considered as a preventative for HIV in the way that some drugs are currently used to help curb the spread of HSV. In my mind, that's a pretty exciting possibility.

While I think you make many valid points, I wanted to play devil's advocate for a second and ask...how is this argument different than those who argue that the HPV vaccine will make teenagers more likely to have sex at a younger age?

Obviously, there are pretty serious issues surrounding adherence on a medication like this, but anti-herpetic drugs & even oral contraceptives have similar issues, no? While I'm sure that people do share those kinds of medications, and obviously don't always take them appropriately, I think an educational campaign could help address these issues while still giving effected populations access to a potentially life-saving medication.

From a public health perspective, I wonder what the costs really are. Is the cost of providing a medication like Truvada to high-risk populations really greater than than providing emergency care to those people once they are infected with HIV? I don't know the answer to that question, and there are obviously a lot of variables, but I hope that's something researchers will look into.

Also, and I don't know if this is a very large population, but what about the "negative" partners of those who are HIV positive? If I were in that position, I think I would probably give very serious thought to a medication that might be able to decrease my risk of contracting the virus.

Do you have a link for this research? I'd love to hear what other HIV Health Activists think, too!

Comment by Sarah on January 29, 2010 at 6:32pm: Marie,

Thanks for playing devil's advocate - I was actually hoping someone would bring up that very idea/opinion with me on this post - because it's essentially how I feel - with a very broad prospective. I don't think that the medication will actually encourage people to have unprotected sex, but I do believe that there will be people who would use it that way - just as there are a few people today who use birth control pills as their "safe sex" plan. I wanted to see if I could start some talk around here, and I've at least managed to do it between you and I!

I would bet, that for certain at-risk communities, where the adherence issues are more strong (poorer, more rural areas) the public health cost would be more than in communities where people were using it perfectly. I can also see that couples with one HIV+ partner to be more interested in this medication than many other people. I wonder if that'd be the population to begin further testing with? Might be something to look at, I guess.

I did some research to see if I could find the PloS One research online, but cannot. I read the article on Business Week, though, so you can at least read things there if you want!

Comment by jen157 on May 12, 2010 at 7:27pm: so how effective is it exactly? I haven't herd anything about it and am wondering what the tests and trials have been...

Comment by Freischütz on November 23, 2010 at 9:11am: Sarah,

This is something that I was thinking too as I read the press release. What is the impact of large scale daily use of these drugs on viral resistance, health effects in other wise healthy people, and what is financial cost of this medicine?

Comment by Freischütz on November 23, 2010 at 9:13am: jen157 the NYTimes has a story today - it was embargoed for release until this morning.

Truvada - not the HIV miracle preventive it seems

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