FOF #1358 – The Battle Over HIV Prevention

Apr 8, 2011 · 1985 views

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The AIDS Healthcare Foundation launched a national ad campaign to discredit PrEP or Pre Exposure Prophylaxis, a new HIV prevention technique that involves taking Truvada (an existing HIV medication) on a daily basis.

Why is the leadership of the nation’s largest AIDS organization arguing against a treatment that could potentially save millions of gay men from becoming HIV positive?

    Comments

  1. Dag says:

    I think this new drug is silly! …don’t be stupid, just stick 2 using a condom!! :o)

  2. jimberly says:

    So if you think it’s silly, don’t take the drug! Condoms work great – if you use them. Not all of us want to use them all the time, or can use them all the time. And many people in relationships – gay and straight – feel they interfere with intimacy. So – for folks like that – this could be an option for protection. Not sure why we should expect that the condom has to be people’s only choice to protect themselves from HIV. We demand choice in every other part of our lives!

  3. jimberly says:

    That’s why the fight for universal health care, and the implementation of the health care reform law Obama passed – remain so critical.

  4. Saulo says:

    Recently in Brazil there is talk on how to move the HIV/AIDS prevention strategy forward. According to some Brazilian AIDS actvists, the “wear condom” recomendation is getting old and we need to look at new ways to tackle the advance of the epidemic.
    Jim is, as always, such a darling helping us make better health decisions… Loved it!
    Smack!

  5. Andy says:

    For guys who are not willing to use a condom this might be an option. But guys who have used condoms before and then use this new pill instead of a condom could get infected as it only reduces the risk by 70%. I can understand why the AIDS organization does not want to promote it when there is a cheaper and more effective solution to prevent HIV.

  6. jimberly says:

    I look at it like this. Driving a car is very, very risky. Many people lose life and limb from auto accidents. The only 100% safe way to drive a car is to not drive – to be abstinent from driving. Not going to happen. So…. to make driving less risky (but never 100% safe) – we have seat belts, airbags, brakes, speed limits, bumpers, stop lights, guard rails on highways and a whole set of shared beliefs and behaviors. We need EACH of those things to help prevent injuries and death due to driving. Take any of them out of the equation and driving becomes even riskier – for all of us. Even with them – people still get hurt. So….. at the moment – we have precious few options to protect ourselves against the sexual transmission of HIV – namely male and female condoms. Abstinence from sex is not an option for most of us. And it has a very high failure rate. Adding in PrEP is simply increasing the size of the prevention toolbox. People who use condoms consistently and correctly should just stick with condoms – if it aint broken, don’t fix it! But if you aren’t using condoms consistently and correctly – taking PrEP is a valid option. Not using a condom is 0% effective after all. And if we are talking about cheaper – a few years of PrEP for appropriate candidates is hundreds of thousands of dollars cheaper than a lifetime of HIV treatment. Thankfully, outside the US – Truvada is available generically. While a year of Truvada (a combination drug consisting of 2 drugs) is over 10k in the US – about $40 a pop – in the developing world it costs between 86 cents and $1.50 per pill.

  7. jimberly says:

    Wanted to add a few things to the above comment.

    I mentioned that Truvada costs $40 per pill here in the US. In developing countries, Gilead provides the drug for between 86 cents and $1.50 through it’s access program. Importantly, through agreements with generic manufacturers, the cost can be as low as 39 cents a tablet.

    It is clear that US citiziens will pay the highest costs – as we do with every single other drug. Gilead has mentioned they may set up something similar to their drug treattment access program, for prevention. We have heard that insurance companies are NOT balking at covering PrEP, actually. They likely see the long-term cost savings of putting someone on PrEP for a few years compared to a lifetime of treatment costs. Incidentally, my treatment costs are about $23,000 per year – 3 drugs. And that cost will only increase.

    Gilead’s tenofovir (another anti-HIV drug) is also being studied as oral prevention. No results are out yet. When used as part of treatment in the US – the cost is $25/pill. In developing countries, Gilead provides the drug for between 55 and 99 cents through its access program. And via generic, it can be as low as 23 cents a tablet.

    Tenofovir has also been tested, and is being further studied, in gel formulation – both vaginal and rectal. Tenofovir gel was developed by Gilead, and Gilead assigned a co-exclusive, royalty-free license to CONRAD and the International Partnership for Microbicides in 2006. CONRAD granted a sub-license to the Technology and Innovation Agency, a biotech agency of the South African govt’s Dept of Science and Technology. TIA will identify a pharmaceutical partner in SA to produce and market the gel in Africa. Because tenofovir gel is not yet being manufactured for widespread use (outside of trials), the eventual cost of the product is unknown and will likely depend on the scale of manufacture and on the cost of the applicator —- in the CAPRISA 004 trial, which was a South African trial that showed tenofovir gel could protect against HIV and herpes in women, the applicator accounted for most of the cost.

  8. TheMightyArdech says:

    Would you please send me any photos you have of people who have died of AIDS…Send me the name birth and date of passing…I will do something beautiful with them…30 years HIV + those are my credentials…SEND THEM TO ardech@ive.ca
    I hope to have the project done by my fiftyith birthday in november

    Thank You
    The Mighty Ardech

    ps You will know when I am done “The world will know”

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