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GOOD MEDICINE

STUDY: Gay Men With Lots Of Partners Should Take Daily Pill To Prevent HIV

A new study by scientists at Stanford University suggests gay men who have five or more sex partners a year could benefit from taking a daily pill to ward off HIV.

The study, cost-benefit analysis published in the Annals of Internal Medicine, looked at the costs involved with prescribing Truvada (tenofovir-emtricitabine) to men who had sex with enough men to put them in a higher risk category for HIV.

In a 2010 trial, Truvada was shown to prevent HIV infections in almost 75% of men who have sex with men (MSM) who took it regularly. Though right now Truvada is only available as a treatment for people with HIV, its maker, made by Gilead Sciences Inc, is trying to get approval to market it as preventative care.

But there’s a financial factor to pre-exposure prophylaxis (PrEP), as the strategy is called : “Promoting PrEP to all men who have sex with men could be prohibitively expensive,” Jessie Juusola, who authored the Standford study, told the Daily News. “Adopting it for men who have sex with men at high risk of acquiring HIV, however, is an investment with good value that does not break the bank.”

Here’s the math:

* Prescribing Truvada to all gay guys would cost $495 billion over two decades. But only prescribing it to high-risk gay men lowers the cost to $85 billion.

* Right now, the CDC predicts 500,000 new HIV infections in the U.S. the next 20 years. If 1 in 5  gay men took Truvida daily, it would prevent 63,000  of those.

* If even just 1 in 5 high-risk men took the drug, 41,000 new infections would be prevented.

So long as there wasn’t harmful side-effects, we say give ‘em the drugs—It’s not often something saves lives and money.

By:           Dan Avery
On:           Apr 20, 2012
Tagged: , , , , ,
  • 46 Comments
    • James D.
      James D.

      Um, I think I’ll stick with a less costly more effective way of preventing HIV, you know…..CONDOMS! Ugh.

      Apr 20, 2012 at 6:37 am · @ReplyReply to this comment ·
    • QJ201
      QJ201

      I love how it is about how many partners…without even clarifying safer, condoms or not.

      Again demonizing “promiscuity”

      I spent my youth slutting around…with condoms and am duh, HIV negative today.

      Apr 20, 2012 at 7:34 am · @ReplyReply to this comment ·
    • Dawn
      Dawn

      Why is this just for gay men. Women can also be high risk. This just goes back to the old stereotype thay HIV is a gay disease.

      Apr 20, 2012 at 7:36 am · @ReplyReply to this comment ·
    • mike128
      mike128

      @QJ201: Agreed. That was my first reaction as well! Use a condom unless you’re certain that you’re in a monogamous relationship with an HIV- partner.

      Also, I wonder who funded this study. Anyone who might have an interest in an 85-495 billion dollar market?

      Apr 20, 2012 at 7:49 am · @ReplyReply to this comment ·
    • JD
      JD

      “lots of partners” = 5 a year? Seriously? LOL

      Apr 20, 2012 at 8:04 am · @ReplyReply to this comment ·
    • Patrick Garies
      Patrick Garies

      I’m curious as to how much of that half-trillion is profit. The price tag sounds awfully steep for a pill even if it is a daily pill for a lot of people over 20 years.

      Apr 20, 2012 at 8:11 am · @ReplyReply to this comment ·
    • iDavid
      iDavid

      Cannot we replace “slut” and “promiscuous” with Hot Sex Machine with a Turbo Sex Drive? It’s far hotter and more positive sounding and doesn’t carry putred religious stench with it.

      Apr 20, 2012 at 8:20 am · @ReplyReply to this comment ·
    • nsanashville
      nsanashville

      5 in a year? are they serious?

      Apr 20, 2012 at 8:40 am · @ReplyReply to this comment ·
    • Bob
      Bob

      @JD: I agree…5??? I am almost 60 and have at least 25 partners a year.

      Apr 20, 2012 at 8:41 am · @ReplyReply to this comment ·
    • Martin
      Martin

      @Dawn: No it goes back to the FACT that gay men are MUCH more at risk than women darling. So please pack your feminism away…
      Not only do gay men have more partners, prevalence of disease is higher but also the pathoanatomical mechanism of transmission (anal sex vs vaginal sex) puts gay men more at risk.

      Will womens envy know no limits???

      Apr 20, 2012 at 9:03 am · @ReplyReply to this comment ·
    • Trent Abroad
      Trent Abroad

      I don’t understand the resistance on this. They’re not being mandated. If you want the extra level of protection, take it. Otherwise… don’t. After further study has been done, I would happily take a daily pill (while still using condoms) just to be safe. HIV is no longer a certain death sentence, but it’s still very serious and what’s wrong with one more tool for prevention?

      On a lighter note: 5 IS a ridiculously low number to constitute promiscuous… for any orientation.

      Apr 20, 2012 at 9:05 am · @ReplyReply to this comment ·
    • Trent
      Trent

      @Trent Abroad: I want you to know I had to read your post because I thought I posted it, because I am Trent and I live abroad currently. Interesting… but back to the point.

      The PEP protocol that they are describing is like Hiroshima for your body. I know, I have taken it. If a condom breaks or something while your are abroad they give it to you as a preventive. The pill though gives you fatigue, curbs your appetite, and has many other fun side effects. Is it better than get HIV, of course. Would you want to be taking it everyday? NO.

      Apr 20, 2012 at 9:16 am · @ReplyReply to this comment ·
    • Martin
      Martin

      Lets make a Facebook group condemning the misogynistic scientist at Stanford who did not include women in the study on gay men and demand at the sime time equal allocation of research money for prostate cancer in men and women. Why be limited by stereotypes Dawn, right?

      Apr 20, 2012 at 9:21 am · @ReplyReply to this comment ·
    • Dawn
      Dawn

      @Martin: Envy?

      Apr 20, 2012 at 9:41 am · @ReplyReply to this comment ·
    • michael
      michael

      5??? We are talking about men, right? As in men, both straight and gay, don’t say “no”. 5 a day wouldn’t be hard to achieve. It’s unreal they think 5 a year is a lot. If you’re not getting laid once a month then there is something wrong w ity you.

      Apr 20, 2012 at 9:42 am · @ReplyReply to this comment ·
    • v
      v

      @trent points out the side effects of taking this medication daily. Making it broadly available isn’t the answer. Decrying sex phobic labeling and raising men vs. women issues doesn’t change the facts of transmission and prevention. We know the risk factors for contracting HIV. Limiting the number of partners, abstaining from high risk practices with them, and always using condoms are prudent measures employed to avoid HIV and other STDs. Yes there are cases of men contracting HIV from a lying monogamous partner or a one time only slip. Many more are the result of careless behavior.

      Apr 20, 2012 at 9:43 am · @ReplyReply to this comment ·
    • Dawn
      Dawn

      @Martin: I was only making a point that women can be high risk too. Women have more than 5 partners a year. They also have anal sex. If someone wants to do a study on just gay men that’s fine. But people keep focusing o HIV as a gay disease and so straight people don’t always protect themselves like they should. That was my point.

      Trust me I don’t envy men. I don’t want to be one. Nor do I hate men. Most of the are great.

      No need to be an ass hat.

      Apr 20, 2012 at 9:46 am · @ReplyReply to this comment ·
    • Martin
      Martin

      @Dawn: Honey, you mentioned women, not straight men right, only women…
      Focus is precisely important in health science. First of all because a study can only test one hypothesis at a time, so including women would kinda confuse things.
      Second prevention must be targeted or focused if you like to a specific group and in this case it was gay men, its mentioned on a gay blog because for reasons stated the issue og HIV prevention pertains particularly to gay men. So take your talk about women somewhere relevant, please… :)

      Apr 20, 2012 at 9:59 am · @ReplyReply to this comment ·
    • Gregg
      Gregg

      1. Juusola isn’t a “scientist,” she’s an industrial engineer.
      2. The work focuses on MSMs (note that MSM != gay) as they are a high-risk group for HIV contraction. Furthermore, the statistics used in the study likely are based on research on MSMs. Modeling a broader population would muddle the results.
      3. Knowing Juusola’s (and Margaret Brandeau’s) prior work on HIV intervention cost-effectiveness, the results are based on mathematical models and statistics. You can debate whether 5 different partners in a year is “lots of partners” (note that is Queerty’s wording–not Juusola’s), but it doesn’t invalidate the cost-effectiveness research or the policy implications.

      Apr 20, 2012 at 10:31 am · @ReplyReply to this comment ·
    • Gregg
      Gregg

      @mike128 Here are the funding sources for the study: National Institute on Drug Abuse, Department of Veterans Affairs, and National Institute of Allergy and Infectious Diseases.

      Apr 20, 2012 at 10:36 am · @ReplyReply to this comment ·
    • iDavid
      iDavid

      This pill costs a raping greedy Piece of Shit price of $26/day, $730/mo. The scumbag drug pushers can fuck right off, I’ll stick to condoms. How fucking many learn jets and Rolls Royces do those crooked nose wallet thugs need?

      Time for a day after pill and put these jokers out if buzz. THAT I’d pay $26 for.

      http://sanfrancisco.cbslocal.com/2012/04/18/uc-scientists-testing-hiv-prevention-pill/

      Apr 20, 2012 at 10:40 am · @ReplyReply to this comment ·
    • pedro
      pedro

      1. Your number of sexual partners per annum doesn’t equal the number of times you actually have sexual intercourse in a given year…some people are slow of wit…

      2.Gay men are still being infected with HIV at double the rate of heterosexuals:http://www.cdc.gov/hiv/topics/surveillance/basic.htm.

      In 2009, 24,000 male + male diagnosed infections as opposed to 12,000 male + female diagnosed infections…Black gay men are at highest risks…I know some people are always screaming that hets are just as promiscuous but the data isn’t showing this, sorry…

      Apr 20, 2012 at 10:41 am · @ReplyReply to this comment ·
    • Mike
      Mike

      Dawn I agree, a lot of people especially straight people seem to think that HIV and having safer sex is something that only bisexual and gay men, IV drug users, and prostitutes need to worry about.

      This pill isn’t going to prevent HIV and people will just take it thinking that it’s a cure and they’ll just bareback anyway.

      Apr 20, 2012 at 10:49 am · @ReplyReply to this comment ·
    • cam
      cam

      They keep talking about the cost of this as if it’s something that taxpayers will pay. It’s going to be insurance or people themselves paying for it so whats the problem?

      Do a large scale buy from the company and have the bulk price reduced….

      Oh WAIT, thats right, the Republicans, who claim that govt. healthcare is bad and would raise prices do not allow the U.S. to argue for lower prices for a large medicine buy from drug companies…..which is why most medicines are cheaper in Canada.

      Apr 20, 2012 at 10:56 am · @ReplyReply to this comment ·
    • Dave
      Dave

      @ martin “Not only do gay men have more partners” this is a stereotype, a lie and unhelpful.
      “Women’s envy” please, Dawn apparently believes this is an attempt to help protect us from HIV and would just like for women to have the same protection. @michael “If you’re not getting laid once a month then there is something wrong w ity you.” Wow, then there must really be something wrong with me, 6 partners in my lifetime,and last time I got laid maybe 3 months ago. @bob “I am almost 60 and have at least 25 partners a year.” Good for you I’m 32 and am not sure if I would have the energy to find 25 sex partners per year now. I do think release of this drug as a daily preventative would be all about money. But it certainly could be beneficial in reducing the spread of HIV. I hope this happens.

      Apr 20, 2012 at 11:11 am · @ReplyReply to this comment ·
    • Bob
      Bob

      @Martin: How about an equal or even half the amount spent on breast cancer compared to that spent prostate cancer?

      Apr 20, 2012 at 11:12 am · @ReplyReply to this comment ·
    • Jamie
      Jamie

      I wonder what the long term side effects of this. Providing medication that was meant for people living with HIV to HIV-negative people seems dangerous. These medications are extremely potent and toxic, taking this every day when you don’t have to seems silly.

      Wear a condom, limit your partners, and be safe!

      Apr 20, 2012 at 11:19 am · @ReplyReply to this comment ·
    • I get it too
      I get it too

      @Trent, I agree. The side effects are a real obstacle and in my opinion make widespread use of PrEP a fantasy. I too took Truvada for a month as post-exposure prophylaxis because of a safe-sex accident. The drug caused me to have a feeling of general malaise that was very unpleasant. It is liver-toxic, among other things. I was very glad when the 4 weeks were up.

      Apr 20, 2012 at 11:55 am · @ReplyReply to this comment ·
    • JayKay
      JayKay

      I guess telling them to just stop behaving like whores is out of the question then?

      Apr 20, 2012 at 12:00 pm · @ReplyReply to this comment ·
    • Martin
      Martin

      @Bob: Bob its called sarcasm :)

      @Dave: No dave its a fact. Very few women have 25+ different partners a year and as you can see from comments not many here consider 5+ to be a lot.

      It is not a stereotype that gay men are at a higher risk for HIV and other STDs. So lets talk about it on our own blog without any women muddling up the issue by talking about women totally out of context. Some women just cant cope with a discussion taling place that doesnt involve them…

      @Mike: Good observation Mike. If we could prevent disease in groups you just mentioned about 90% cases would be prevented. But youre right of course lets be politically correct and not focus prevention. Lets be inclusive, forget about stereotypes and talk about the spectre of straight womens HIV risk

      Apr 20, 2012 at 12:08 pm · @ReplyReply to this comment ·
    • gggggb
      gggggb

      Five or more partners a year is considered a lot? What is the average for straight people? I feel like I would not have considered myself to be in this category, but that’s a pretty frighteningly small number for 365 days. What do they do on every other day?

      Apr 20, 2012 at 2:14 pm · @ReplyReply to this comment ·
    • pedro
      pedro

      @gggggb: Umm…I know this is a hard concept for you to understand…but a person could have just one partner and still have sex 365 days a year…Is there a “you can only have sex with a particular person once” rule in the gay ghetto that I’m unfamiliar with? It seems as if the concept of monogamy is going straight over the heads of the Grindr set….

      Apr 20, 2012 at 2:23 pm · @ReplyReply to this comment ·
    • Weaponry
      Weaponry

      I think it’s sad that we would rather market a daily drug to people, a drug that can have real and dangerous side effects, rather than encourage people to show restraint by using safer sex practices.

      Apr 20, 2012 at 2:42 pm · @ReplyReply to this comment ·
    • I get it too
      I get it too

      The number of partners doesn’t matter if the sex is safe. Why is that so hard for researchers to understand?

      Apr 20, 2012 at 3:45 pm · @ReplyReply to this comment ·
    • matt
      matt

      I don’t think it’s homophobic to say that gay men have more sex partners than straights do, it’s not that we’re gay, it’s that we’re men. If straight women were as interested in hooking up as straight men were, then they would be a lot more promiscuous too. From what I have been told hooking up is simply not as enjoyable for a women, often times they need someone who knows them and how pleasure them from experience for them to enjoy it and have an orgasm.

      Apr 20, 2012 at 3:51 pm · @ReplyReply to this comment ·
    • Bipolar Bear
      Bipolar Bear

      @James D.: Exactly! Who sponsored this study, Gilead? These drug companies should be focussing their attention on continuing to develop new therapies for the millions who already have HIV and are developing resistance to existing combos, rather than trying to cynically increase their market share.

      Apr 20, 2012 at 5:22 pm · @ReplyReply to this comment ·
    • steve
      steve

      Well, sounds like we should all be taking this pill lol, I love how there’s no talk about CONDOMS!

      Apr 20, 2012 at 6:21 pm · @ReplyReply to this comment ·
    • iDavid
      iDavid

      Maybe a woman could chime in on this, but my interpretation as to why more women aren’t recreational sex-active is due to: 1. Getting pregnant 2. Reputation i.e. religious influence Madonna/Whore complex 3. Possibility of getting raped.
      4. Wants a deeper connection.
      The kicker is woman are just as horny as men and masturbate just as much, but live with fears and rules we don’t have.

      Apr 20, 2012 at 8:16 pm · @ReplyReply to this comment ·
    • Justin Huang
      Justin Huang

      @JD: yeah… that scared me too.

      Apr 21, 2012 at 8:22 am · @ReplyReply to this comment ·
    • Scott
      Scott

      @Martin
      “Not only do gay men have more partners…”

      You make us ugly people feel discriminated against. Only pretty people get lots of partners.

      Apr 21, 2012 at 11:22 am · @ReplyReply to this comment ·
    • sandy k
      sandy k

      Odviously those who perform in the bareback porn (if they are not already infected), should consider this a serious recommendation!

      Apr 21, 2012 at 7:28 pm · @ReplyReply to this comment ·
    • lemon-lime
      lemon-lime

      @JD: If you’re averaging more than 5 different partners a year, that makes you a slut, yes. Is this limited to gay men? No. A lot of men, simply put, are sluts. *shrug*

      Apr 22, 2012 at 10:00 pm · @ReplyReply to this comment ·
    • frank
      frank

      @Dawn: How many straight people do you know with HIV in America?

      Apr 24, 2012 at 8:37 am · @ReplyReply to this comment ·
    • frank
      frank

      All HIV medication – and all life-saving medications – should be free. Pharma companies make more than enough money to afford this and not let people die because of their greed.

      Apr 24, 2012 at 8:40 am · @ReplyReply to this comment ·
    • DB
      DB

      @gggggb: @michael: You said 5 sexual partners is a “frighteningly small number for 365 days. What do they do on every other day?” I have sex at least three times a week and I only have sex with one person a year. My husband does the same. At least 75% of my gay male friends and more than half of my heterosexual and gay female friends are also monogamous. The idea that you think monogamous (or even non-monogamous but not extremely promiscuous) people have less sex is ridculous (and frankly, idiotic).

      Apr 24, 2012 at 3:27 pm · @ReplyReply to this comment ·
    • David
      David

      Logically, if they increase the market to include people that don’t have HIV yet, that should lead to lower prices because (allegedly) the high price of brand name drugs is to cover the research to make the drug in the first place.

      I’d love to be able to take it as a preventative measure. My standards haven’t let me down so far, but I came from an area where HIV was basically non-existent to a major metropolitan area, and, quite frankly, the number of guys that are HIV+ is rather unsettling.

      @lemon-lime: I’ve had 6 sexual partners this month, and that’s really not that much for a gay man. (Straight guys do have to jump through a lot of hoops to get some; we’ve got A4A, Grindr, and the like.) I did go through a slut phase (after my first attempt at a straight-style relationship with a guy failed miserably) where I averaged around 3-5 partners in a week, but what I really consider to have made me a slut was my standards. I might have sex with a lot of guys, but I don’t just say “hi” and then take my clothes off anymore. Even when you are trying to find a real relationship, sex on the first date is pretty much expected. I’m not having sex with total strangers; I trust these guys a decent amount; so, you can’t really call me a slut.

      Apr 28, 2012 at 6:53 am · @ReplyReply to this comment ·

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