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Back to Section One | Back to Arts & Entertainment
posted Friday, March 18, 2011 - Volume 39 Issue 11
Section One
ALL STORIES
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AIDS Healthcare Foundation skeptical of drug Truvada

by Mike Andrew - SGN Staff Writer

The AIDS Healthcare Foundation is running full-page ads warning that the drug Truvada may not be effective for HIV prevention.

The ads took the form of an open letter to Gilead Sciences, the makers of Truvada.

Last November, a study published in the New England Journal of Medicine suggested that Truvada - which was being used as an anti-retroviral drug to treat existing HIV infections - might also be effective at blocking transmission of HIV.

When the study was announced, it sparked hopes that Truvada might be an effective PrEP (pre-exposure prophylaxis) drug, meaning that using the drug before actual exposure to the virus would help prevent infection.

Not so fast, the AIDS Healthcare Foundation said.

'AHF supports continued research on HIV prevention, but opposes quick fixes that run the risk of contributing to the spread of HIV and drug-resistant viruses,' the group said in its open letter.

Noting that the November study showed only a 44% effectiveness rate in blocking new HIV infections, AHF concluded that 'Such modest results are insufficient to support FDA approval of Truvada as an HIV prevention tool for Gay men.'

The AHF also challenged the applicability of the study.

'Real-world information is lacking,' AHF said. 'The 44% who received a benefit from Truvada were intensively counseled monthly and tested frequently for sexual infections. This is in no way representative of the real world.'

Relying on Truvada might actually increase health risks for individuals and the wider community, AHF warned.

'How likely are uninfected men to take pills every day for the rest of their lives to prevent a possible HIV infection?' AHF asked. 'The consequences of patients who take Truvada haphazardly are that they will become infected, develop drug resistance, and spread drug-resistant virus to others.'

'Condoms work,' AHF added. 'Prevention using Truvada has not been shown to be as effective as condom use.'

AHF worried that men using Truvada or other PrEP drugs might become lax in using condoms.

'It is logical to assume that if patients are taking a drug that they believe will prevent them from becoming HIV-positive, they will be more lax in their use of condoms,' the foundation said. 'There may be men who are currently using condoms 100% of the time who will stop using them because of a false sense of protection from taking PrEP.'

Reacting to AHF's statement, Jeff Berry, editor of Positively Aware, called for more study of Truvada's possible benefits.

'For those populations who may be at higher risk,' he said, 'or who may not have the luxury of having all of the tools at their disposal (for example, men or women whose partners are unwilling or unable to use a condom or other form of protection), if they could use a microbicide gel or even a pill to lessen their risk, why would we not want that?

'Oral PrEP (if proven safe and effective), vaginal and rectal microbicides, condoms, risk-reduction and adherence counseling, treatment as prevention - all of these and other methods must be allowed to be fully explored and studied.'

The AIDS Healthcare Foundation describes itself as 'a global organization providing cutting-edge medicine and advocacy to over 100,000 people in 22 countries. It is the nation's largest provider of HIV/AIDS medical care.'

Positively Aware is the online journal of the Test Positive Aware Network, a group that offers peer counseling, support programs and services, and advocacy to HIV-positive people.

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