HIV prevention project lauded
Just over 2,000 B.C. residents have taken medication to prevent HIV in the six months since it became publicly funded, Health Minister Adrian Dix says.
The treatment is taken either before or after high-risk sex and is formally called pre- or post-exposure prophylaxis. The oral medication, Truvada, or an approved generic equivalent, can be prescribed to men having unsafe sex with other men. It can also be prescribed to men or women having sex with people who inject street drugs or with people infected with HIV.
Similar treatment has been publicly funded for years for those exposed to HIV through, for example, a sexual assault or in the workplace.
HIV is now an uncommon illness in B.C. Last year there were fewer than 200 cases, a 90 per cent drop from the height of the AIDS epidemic in the 1980s.
Nearly 7,300 individuals are living with HIV in B.C. They take daily, oral medication said to be over 90 per cent effective in preventing the conversion to AIDS.
The government would not reveal how much it’s spending on the new preventive drugs because it negotiates pricing with pharmaceutical companies. It’s believed to be as high as $850 a month, depending on which drug cocktail is prescribed.
Dix told a press conference that the preventive treatment is part of a $19.9 million a year program to expand the treatment as a prevention strategy developed by Dr. Julio Montaner and the St. Paul’s Hospital-based B.C. Centre for Excellence in HIV/AIDS.
Dix called Montaner an “exceptional advocate” and part of a team of Vancouver researchers who can honestly claim they have “saved tens of thousands of lives.”
Montaner said the news conference was more than just an announcement that more HIV infections are being prevented.
“We are trying to set an example for the rest of country, and for the rest of the world, that this is an efficient, cost-effective way to achieve an end to this epidemic.”
B.C. is the only province paying for the treatment as prevention program and, as a result, the only one to realize a steady decline in new HIV cases, Dix said.
“The expansion of coverage … keeps B.C. at the forefront of fighting the spread of HIV and AIDS,” said Dix.
While Dix and Montaner celebrated the first six months of the preventive strategy, research done outside of Vancouver has shown it has unintended consequences.
A study published this month in the journal Lancet HIV found men on the preventive drugs are far less likely to use a condom. The percentage not using a condoms rose from one per cent to 16 per cent.
Said a study co-author: “A rapid increase in (preventive drug) use by gay and bisexual men in Melbourne and Sydney was accompanied by an equally rapid decrease in consistent condom use.”
Montaner said local experts are watching for that.
“So far, we haven’t seen that yet, but it’s early days,” he said.
Some local health experts are concerned individuals on the preventive medication might become resistant to it or have “breakthrough” infections, he acknowledged.
He also conceded that because of unsafe sex practices, Vancouver is in the grips of an epidemic of sexually transmitted infections such as syphilis, gonorrhea and chlamydia.