On July 16, 2012 the U.S. Food and Drug Administration announced that it had approved the drug Truvada for use in HIV prevention. Truvada, a drug commonly used to treat HIV, became the first medication to be approved to prevent the spread of HIV. Good news….right? Well, yes, and no.
Pre-exposure Prophylaxis, or PrEP, has been used for years to decrease the risk to an infant born to an HIV+ pregnant woman. The HIV+ mom takes HIV medications by mouth during her pregnancy, an HIV medication is given intravenously (IV) during labor/delivery and the newborn is given an HIV medication for six weeks following birth. This regimen of medications has proven to be dramatically effective in all but eliminating HIV risk to a newborn. But, to truly protect that newborn, adherence to all key pieces has to occur.
When approving Truvada to be used for HIV prevention in people with a high risk of contracting HIV, the FDA emphasized routine HIV testing every three months and the continued use of condoms.
So if those key pieces are strictly adhered to: taking Truvada daily, always using condoms, and routinely getting tested for HIV, we may similarly see a decline in HIV transmission.
But human nature being what it is, medication doses may be skipped, condoms may not be handy or forgotten, and how many months will it really be before a patient returns for that pesky three-month test (I’m thinking of my own experience with keeping six-month dental appointments).
Annually, about 50,000 people living in the United States are diagnosed with HIV. Health care providers have an opportunity to change that statistic. Individuals will need a prescription to obtain Truvada. This presents a unique opportunity to discuss individual risk factors and all the components necessary to assure that transmission of HIV will not occur.
So, while Truvada may be effective in decreasing the risk of acquiring HIV, it is just one part of the equation. To truly ensure the success of decreasing HIV transmission, it will take the diligence of the medical community to educate and work with consumers, as well as a strict regimen and personal responsibility by those taking Truvada in following the guidelines.