Sexually active people, including at-risk gay men, may soon be able to easily get their doctors to prescribe them a pill that prevents the contraction of AIDS.

In what ABC News hails as a major blow against the AIDS epidemic, the FDA has cleared the way for preventative uses of Truvada, a drug already prescribed to make AIDS manageable in HIV-positive patients:

The Food and Drug Administration said Tuesday that Gilead Sciences’ Truvada appears to be safe and effective for HIV prevention. It concluded that taking the pill daily could spare patients “infection with a serious and life-threatening illness that requires lifelong treatment.”

On Thursday a panel of FDA advisers will consider the review when it votes on whether Truvada should be approved as a preventative treatment for people who are at high risk of contracting HIV through sexual intercourse. The FDA is not required to follow the advice of its panels, but it usually does…

Researchers first reported that Truvada could prevent people from contracting HIV in 2010. A three-year study found that daily doses cut the risk of infection in healthy gay and bisexual men by 44 percent, when accompanied by condoms and counseling. Another study found that Truvada reduced infection by 75 percent in heterosexual couples in which one partner was infected with HIV and the other was not.

Is a reduction of 44 percent that impressive though, given that condoms were still being used? Condoms are 99.9 percent effective, unless used sloppily or in the oft chance they break, right?

We’d like to know what the risk reduction factor is when only condoms are used, in order to compare that to the Truvada-added study as a control. This is especially important given that the drug is very expensive as compared to condoms: about $12,000 a year (you have to take it daily for it to work, say doctors), which would cost the government $500 billion over 20 years to cover all gay men.

A 75 percent decrease in a couple where one is infected and the other not, well, that’s truly remarkable. Could the most promising use for Truvada be to alleviate the fears of HIV-positive people in relationships with negative partners?

Perhaps this would cause more infected partners to disclose their statuses to one-night stands and long-term lovers, too. We’ve heard around that a fair amount of positive gay men still take people home from bars and don’t tell them their status.

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