PreP, a new drug which temporarily boosts immunity to people who’ve been exposed to the HIV retrovirus is beginning a massive human clinical trial on three separate continents, but also causing medical professionals to question whether such a pill could actually cause more HIV infections if found effective. Doctors are concerned that users of the pill may stop using condoms and other protective measures if the pill was made available on a mass scale.
ABC News reports on the mixed blessing the new treatment could provide:
“The pre-exposure pill undergoing testing seems promising, since HIV drugs taken within days after exposure to the virus have been shown to reduce the risk of infection by 80 percent. But public health officials debate whether people at high risk for the virus, such as men who have sex with men, would be more likely to set aside the use of condoms to instead rely on a drug regimen that doesn’t provide full protection against the disease, which is spread by contact with the blood or semen of an infected person.
Dennis, a 47-year-old gay man from Atlanta, is one of the test subjects for the new pill. He calls himself “blessed” for escaping the HIV epidemic that hit many of his friends in the 1980s. But his HIV-negative status hasn’t stopped him from having sex with infected partners.
“If you just say that you’re not going to have sex with anyone who’s HIV positive , here you’re eliminating a whole bunch of wonderful people,” said Dennis, who asked that his last name be withheld. “How shallow would that be?”
He was recruited for the clinical trial for PreP, or pre-exposure prophylaxis for HIV prevention, with a drug called tenofovir.
“I was eager to take it,” said Dennis. Since he was already using condoms, he said, “It couldn’t hurt. I’ll know in June if I was taking the real McCoy, or if it was the fake pill.”
Soon after he started the trial, he noticed the doctors were trying to study his behavior as much as the drug’s side effects. Each time he went for a monthly checkup, HIV test and counseling, Dennis said the director of the study, Lynwood Miller at the AIDS Research Consortium of Atlanta, kept asking him about his sex practices.
“I don’t think I was any more promiscuous just because I was taking the drug,” he said. “I didn’t put myself at risk just to test the drug. I’m not that crazy.”
Darth Paul
Neither this drug nor post-exposure prophylaxis is anything new.
Trog
Also, just to clarify: PrEP is taken BEFORE possible exposure. PEP is taken afterward, preferably withing 36 or 72 hours of exposure.
Qjersey
What they are really worried about is a spike in other STDs if PREP is effective. I’m sorry, but the way some guys run around and bareback without a thought, I’ll stick to using condoms. I learned my lesson years ago after catching chlamydia…I don’t ever want to be standing at the toilet screaming while I pee ever again. (oh yeah and the guy I got it from? a regular buddy which is what lead to the condoms going ashtray after numerous play dates… and there were no more after that).
Pragmatist
I’m not sure I “get” the purpose of this treatment. If it’s anything like PEP, it causes a host of really miserable side effects. What sane person would futz with his immune system, and suffer those side effects, just to have some unprotected sex?
Secondarily, I wonder how the researchers who designed this study dealt with its ethical ramifications as far as the test subjects are concerned. Since each subject had a 50% chance of getting a non-placebo, each subject’s expected risk of infection would have decreased by a percentage of 0.5 * (whatever reduction the active medication is expected to provide). That knowledge might register in the subjects’ minds subconsciously, causing them to engage in riskier practices — even though half of them are receiving placebo. Just a thought.