Pre-Exposure Prophylaxis & HIV Prevention: More harm than good?

Pre-Exposure Prophylaxis (PrEP) for HIV is a type of drug used before exposure to the virus, somewhat like a preemptive measure against HIV transmission. The purpose a PrEP drug is to prevent the infection, rather than treat the symptoms or cure AIDS.

In July 2012, the US FDA approved the PrEP drug Truvada to reduce the risk of sexually acquired HIV infection.

Debates have since sprung up on the effectiveness of prescribing what amounts to a chemotherapeutic drug to perfectly healthy people. Truvada works if taken every day. For a lifetime. Could such a “miracle drug” truly work to prevent the spread of HIV/AIDS?

Let’s look at the arguments.

The goal of PrEP drug is to reduce the risk of HIV infection amongst those who engage in high-risk sexual behaviour, such as sex workers and those who engage in activities with sex workers. While using a condom should always be the first line of defense, many wonder if such “carefree” and “reckless” individuals will be disciplined enough to take the drug daily.

Truvada itself is a costly drug, estimated at $13K per annum. While this seems to be a perfectly fair price to pay for the wealthy, questions remains on coverage by medical policies, as well as subsidies by the local governments. Such a drug would quickly cripple the funds of developing nations, which are countries with some of the highest HIV prevalence. There are fear that other medical causes, such as TB and malaria, will be affected.

On the other side of the debate, to prescribe such preventive medication to perfectly healthy people is not uncommon. Think of the vaccinations for flu, chicken pox and hepatitis B. These drugs saved lives in the millions. Why should Truvada be treated any differently?

As responsible HIV advocates, we must be vigilant in our examinations of the facts and to balance both side of the scale. Such a prevention strategy needs to be evaluated careful. Don’t jump in blindly.

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