A new chapter in AIDS history: Truvada brings pharmaceutical prevention

We ve been following the increasingly promising anti-HIV drug Truvada ever since a 2010 study showed that it was capable of reducing HIV transmission between male partners by as much as 90 percent. Later trials showed the pill s efficacy in heterosexual couples as well, and this July the FDA approved Truvada for use by uninfected people who are at high risk of being infected with HIV. Adding to this momentum, the Centers for Disease Control and Prevention (CDC) has just issued guidelines for preventive use of the drug among uninfected heterosexuals.

Used as a pre-exposure prophylaxis, Truvada, a combination of two anti-retroviral drugs, must be taken daily and used in conjunction with regular screening and conventional barrier methods such as condoms. The method is intended most specifically for uninfected people whose partners are HIV positive.

Given that an estimated 48,000 HIV infections occurred in the U.S. in 2009, while 1.2 million people in the U.S. are living with HIV infection 20 percent of whom are unaware of their condition health experts believe that Truvada could help lower the annual rate of new infections.

Nevertheless, public knowledge of and access to Truvada is still very low. As ACSH s Dr. Gilbert Ross pointed out in a recent op-ed, only about one-fourth of HIV patients are currently getting effective treatment; to educate the overwhelming majority of HIV-positive individuals and their partners will take a significant public health effort.

This is groundbreaking, says ACSH s Dr. Josh Bloom. Antiretroviral drugs have been used very successfully to treat infected people, and have also been shown to drastically reduce transmission from infected men to non-infected women in Africa. But I am not aware of any viral diseases for which prophylactic therapies other than vaccines are used. Long term use of AIDS drugs in healthy people raises some very interesting questions. These drugs are not vitamins, they are serious medicines.