Human Immunodeficiency Virus (HIV) is still a very real, and very serious risk for those that are sexually active, especially with the fact that there are around 50,000 new cases diagnosed even year in the US and it is  approximated that there are 240,000 undiagnosed carriers, unaware of their status, and around 1.2 million Americans live with the disease.  Those numbers are pretty staggering, right? And the FDA did approve a drug, Truvada, to help as a second preventative measure against HIV about a month ago.  But, there is some controversy related to the drugs approval.

How does it work?

Truvada has been on the market since 2004 to treat HIV, and it is two antiretrovial drugs in combination that tenofovir and emtricitabine that has a higher compliance rate because the two medications are fused into one pill.  The drug, in combination with others, help to prevent the replication of the HIV virus within the DNA, which is how the virus spreads, and usually very quickly. The use of antiretrovirals helps to prevent the virus from spreading.

How does it prevent HIV?

Well, the makers of the drugs did numerous studies with couples that have one HIV infected partner and looked at transmission rates.  Of course, they always encourage the partners to use condoms as that is the best way to prevent the spread of infection, creating a barrier technique.  There was one 3-year long study performed looking at gay and bisexual males, along with the use of condoms and counseling, and they found that the rate of HIV transmission was decreased by 42%.  In heterosexual couples with one infected partner, again with the use of condoms, the transmission rate was decreased by 75%. Those are pretty fantastic results, and give a lot of piece of mind for those at high risk.  It was already prescribed by some HCPs to patients that didn’t have HIV with HIV positive partners as an off label use, but now it is big news that the FDA approved it, which means preliminary research supports the fact that it does, in fact, help to prevent the transmission of HIV to those not infected.

Where’s the controversy?

Some HCPs and HIV/AIDS activists worry that people will ask their HCPs for the drug and be more reckless with unsafe sex because they will feel that they are able to engage in high risk activities (multiple partners, no condoms, sharing needles, etc.) and will not become infected with HIV.  That is not the point of the drug.  The drug is to be used by those at risk due to life circumstances, and they are still encouraged to use condoms and are to be counseled related to their risks and other preventative measures.

Remember that HIV can be spread when blood/genital secretions infected with HIV comes into contact with your blood/tissues, like those tissues of the oral/vaginal/anal mucosa, eyes, any cut or break in the skin.  Thus, some behaviors that put you at risk are having sex without condoms, sharing needles (not just for IV drug use, but for tattoos, steroid injections, and body piercing), and infected mothers can transmit to their babies during childbirth or through breast milk.  So try to abstain from these behaviors, and talk to your HCP about getting tested if you think you are at risk, or have been exposed. I happen to think routine testing is a good idea for anyone who is sexually active, so go for it, it will put you mind at ease!  If you your partner is infected, talk to your HCP and see if Truvada is right for you, but STILL USE CONDOMS!!  Have fun, and be safe.

Yours in Good Health

B