Will this pill stop HIV in­fec­tions?

A blue pill is mak­ing its mark on his­tory as clos­est thing to an HIV vac­cine

GA Voice - - Front Page - By DYANA BAGBY dbagby@the­gavoice.com

Join us as we take a look in­side Tru­vada.

Take a pill once a day and you es­sen­tially re­duce your risk of con­tract­ing HIV by al­most 99 per­cent— sounds like this would be an easy idea to back by ac­tivists and physi­cians who want to stop the 50,000 new HIV in­fec­tions each year just in the U.S.

But the story of Tru­vada, the blue pill man­u­fac­tured by Gilead Sci­ences, is just not that sim­ple.

Renowned HIV/AIDS ac­tivist Michael We­in­stein of the AIDS Health­care Foun­da­tion has called Tru­vada a “party drug” while Larry Kramer, whose play ‘The Nor­mal Heart’ was just adapted for TV by HBO, says people who want to pop a pill once a day in­stead of use con­doms must have “rocks in their heads.”

Last month, how­ever, the Cen­ters for Dis­ease Con­trol and Preven­tion re­leased guide­lines for providers on the use of PrEP, or pre-ex­po­sure pro­phy­laxis, that in­cludes Tru­vada as an HIV preven­tion tool along with other safer-sex prac­tices, in­clud­ing con­dom use.

“While a vac­cine or cure may one day end the HIV epi­demic, PrEP is a pow­er­ful tool that has the po­ten­tial to al­ter the course of the U.S. HIV epi­demic to­day,” said Jonathan Mer­min, di­rec­tor of CDC’s Na­tional Cen­ter for HIV/AIDS, Vi­ral Hepati­tis, STD, and TB Preven­tion, in a state­ment. “These guide­lines rep­re­sent an im­por­tant step to­ward fully re­al­iz­ing the prom­ise of PrEP. We should add to this mo­men­tum, work­ing to en­sure that PrEP is used by the right people, in the right way, in the right cir­cum­stances.”

DRUG HIS­TORY

Tru­vada has been mar­keted by Gilead Sci­ences since 2004 as a drug to help in the treat­ment of those who are HIV pos­i­tive. In 2012, the FDA ap­proved Tru­vada as the first drug shown to re­duce HIV in­fec­tion rates—a ma­jor mile­stone in the fight to end the 30year HIV epi­demic.

The FDA ap­proval two years ago came af­ter the ground­break­ing 2010 study, known as iPrEx, which showed that when people—gay and bi­sex­ual men, het­ero­sex­ual men and women and trans­gen­der women—took Tru­vada daily and con­sis­tently, they re­duced their risk of con­tract­ing HIV by 99 per­cent.

Yet no one has been shout­ing the news from the rooftops in Ge­or­gia, which ranks sixth in the na­tion for new HIV in­fec­tions, ac­cord­ing to the CDC. Un­til now. At a re­cent town hall meet­ing hosted by Team Friendly At­lanta, an or­ga­ni­za­tion work­ing to re­duce HIV stigma, pan­elists dis­cussed the need to ed­u­cate the pub­lic about Tru­vada and dis­pel mis­in­for­ma­tion as well as stigma sur­round­ing the drug.

The no­tion that gay men on Tru­vada will be­gin par­tic­i­pat­ing in risky be­hav­iors—or be­come “Tru­vada whores”—hasn’t played out in re­search, said Dale Maddox, a clin­i­cal re­search nurse at Emory Univer­sity School of Medicine AIDS Clin­i­cal Tri­als Unit.

When people are on PrEP they see their doc­tors more of­ten, they are get­ting con­stant care and they are clearly re­duc­ing their risk of con­tract­ing HIV, she ex­plained.

The scare tac­tics that con­doms are the only safe way for gay men to have sex can be com­pared to the con­tro­versy when the birth con­trol pill was ap­proved in the 1960s, Maddox said. Moral­ists de­cried “the pill” as a gate­way to un­tamed promis­cu­ity by sin­gle women, and judg­ment was harsh. But none of the apoc­a­lyp­tic pre­dic­tions of so­ci­ety’s down­fall made back then came to be. To­day, moral­ists can­not de­nounce Tru­vada, a proven ef­fec­tive tool to stop the spread of HIV/AIDS, be­cause it only hurts all of so­ci­ety, Maddox added.

“This is non-judg­men­tal. This is a harm re­duc­tion tech­nique,” she said. “It gives con­trol to the user.”

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