Daily HIV prevention pill recommended for those at risk
The Food and Drug Administration approved Truvada, a pill that combines two antiretroviral drugs for HIV prevention, in 2012.
For years the message was simple:
Use condoms to prevent HIV. But if you are at high risk of contracting the
virus, health experts want you to consider an additional strategy -- taking a
pill every day to reduce your chance of being infected.
New guidelines published by the
Centers for Disease Control and Prevention say pre-exposure prophylaxis, or
PrEP, should be taken daily by people who are at high risk for contracting HIV.
The recommendation is based on
several large national and international studies, which were done in varying
at-risk populations, such as gay and bisexual men, heterosexual couples where
one person is HIV-positive (the other is not) and injection drug users.
The studies all showed that this
drug can help reduce infection rates by more than 90% when taken daily.
"While a vaccine or cure may
one day end the HIV epidemic, PrEP is a powerful tool that has the potential to
alter the course of the U.S. HIV epidemic today," Dr.Jonathan Mermin,
director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB
Prevention, said in a statement.
"These
guidelines represent an important step toward fully realizing the promise of
PrEP. We should add to this momentum, working to ensure that PrEP is used by
the right people, in the right way, in the right circumstances."
According
to the guidelines, those circumstances would be anyone who:
1. has had sex without a condom;
2. is
not infected with HIV but is in a sexual relationship with an HIV-infected
partner;
3. is
a gay or bisexual man who has had a sexually transmitted disease within the
last six months and is
not in a mutually exclusive relationship with a recently
tested HIV-negative partner;
4 is
a heterosexual man or woman who does not always use condoms when having sex
with partners
already at risk, and who isn't in a mutually exclusive
relationship with a recently tested HIV-negative
partner;
Or
•
has injected drugs or shared drug paraphernalia in the past six months
In
2012, the Food and Drug Administration approved Truvada, a pill that combines
two antiretroviral drugs for the prevention of HIV. It was first approved in
2004 as an HIV treatment and is still the only FDA-approved medication for
PrEP.
Truvada
isn't cheap. A month's supply can cost you anywhere from $1,300 to $1,700,
according to Drugs.com. But insurance may cover the bill.
To
be effective, this pill must be taken every day.
Dr.
Anthony Fauci, an immunologist who has been at the forefront of HIV/AIDS
research for decades, called it a highly effective approach to preventing the
spread of the virus that causes AIDS.
The
new guidelines replace interim ones published two years ago; they provide a
comprehensive place where doctors and patients can find information on PrEP and
come with a supplement that provides checklists for physicians, giving them
step-by-step support for dealing with patients who might be considered for
prophylactic treatment.
"PrEP
is a new approach to HIV prevention that requires continuing collaboration
between patients and providers, as effectiveness requires adherence to daily
medication and regular medical visits for monitoring, counseling and
testing," said Dr. Dawn K. Smith, an epidemiologist in CDC's Division of
HIV/AIDS Prevention who led the development of the guidelines.
"Individuals
will have to decide with their doctor if PrEP is right for them, but for some,
this may offer a much-needed strategy to help protect themselves from HIV
infection."
There
are 1.1 million people in the United States living with HIV, according to the
CDC. An estimated nearly one in six do not know they're infected.
Men
who have sex with men are the hardest hit -- while they make up 2% of the U.S.
population, they account for 63% of all new infections each year, according to
the CDC. Heterosexuals make up 25% of all new annual infections; 9% are
injection drug users.
"HIV
infection is preventable, yet every year we see some 50,000 new HIV infections
in the United States," said Dr. Tom Frieden, the CDC's director, in a
statement. "PrEP, used along with other prevention strategies, has the
potential to help at-risk individuals protect themselves and reduce new HIV
infections in the United States."
The Food and Drug Administration approved Truvada, a pill that combines two antiretroviral drugs for HIV prevention, in 2012.
For years the message was simple:
Use condoms to prevent HIV. But if you are at high risk of contracting the
virus, health experts want you to consider an additional strategy -- taking a
pill every day to reduce your chance of being infected.
New guidelines published by the
Centers for Disease Control and Prevention say pre-exposure prophylaxis, or
PrEP, should be taken daily by people who are at high risk for contracting HIV.
The recommendation is based on
several large national and international studies, which were done in varying
at-risk populations, such as gay and bisexual men, heterosexual couples where
one person is HIV-positive (the other is not) and injection drug users.
The studies all showed that this
drug can help reduce infection rates by more than 90% when taken daily.
"While a vaccine or cure may
one day end the HIV epidemic, PrEP is a powerful tool that has the potential to
alter the course of the U.S. HIV epidemic today," Dr.Jonathan Mermin,
director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB
Prevention, said in a statement.
"These
guidelines represent an important step toward fully realizing the promise of
PrEP. We should add to this momentum, working to ensure that PrEP is used by
the right people, in the right way, in the right circumstances."
According
to the guidelines, those circumstances would be anyone who:
1. has had sex without a condom;
2. is
not infected with HIV but is in a sexual relationship with an HIV-infected
partner;
3. is
a gay or bisexual man who has had a sexually transmitted disease within the
last six months and is
not in a mutually exclusive relationship with a recently tested HIV-negative partner;
not in a mutually exclusive relationship with a recently tested HIV-negative partner;
4 is
a heterosexual man or woman who does not always use condoms when having sex
with partners
already at risk, and who isn't in a mutually exclusive relationship with a recently tested HIV-negative
partner;
already at risk, and who isn't in a mutually exclusive relationship with a recently tested HIV-negative
partner;
Or
•
has injected drugs or shared drug paraphernalia in the past six months
In
2012, the Food and Drug Administration approved Truvada, a pill that combines
two antiretroviral drugs for the prevention of HIV. It was first approved in
2004 as an HIV treatment and is still the only FDA-approved medication for
PrEP.
Truvada
isn't cheap. A month's supply can cost you anywhere from $1,300 to $1,700,
according to Drugs.com. But insurance may cover the bill.
To
be effective, this pill must be taken every day.
Dr.
Anthony Fauci, an immunologist who has been at the forefront of HIV/AIDS
research for decades, called it a highly effective approach to preventing the
spread of the virus that causes AIDS.
"(It's)
one that benefits not only the individual patient at risk for HIV infection but
also will help to reduce the number of new HIV infections across the United
States," said Fauci, director of the National Institute of Allergy and
Infectious Diseases at the National Institutes of Health. "It should be
used together with -- and complementary to -- condoms and not as a substitute
for condoms."
The
new guidelines replace interim ones published two years ago; they provide a
comprehensive place where doctors and patients can find information on PrEP and
come with a supplement that provides checklists for physicians, giving them
step-by-step support for dealing with patients who might be considered for
prophylactic treatment.
"PrEP
is a new approach to HIV prevention that requires continuing collaboration
between patients and providers, as effectiveness requires adherence to daily
medication and regular medical visits for monitoring, counseling and
testing," said Dr. Dawn K. Smith, an epidemiologist in CDC's Division of
HIV/AIDS Prevention who led the development of the guidelines.
"Individuals
will have to decide with their doctor if PrEP is right for them, but for some,
this may offer a much-needed strategy to help protect themselves from HIV
infection."
There
are 1.1 million people in the United States living with HIV, according to the
CDC. An estimated nearly one in six do not know they're infected.
Men
who have sex with men are the hardest hit -- while they make up 2% of the U.S.
population, they account for 63% of all new infections each year, according to
the CDC. Heterosexuals make up 25% of all new annual infections; 9% are
injection drug users.
"HIV
infection is preventable, yet every year we see some 50,000 new HIV infections
in the United States," said Dr. Tom Frieden, the CDC's director, in a
statement. "PrEP, used along with other prevention strategies, has the
potential to help at-risk individuals protect themselves and reduce new HIV
infections in the United States."
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