Truvada first entered the market in 2004 as one of many drugs in the HIV treatment cocktail. But in 2010 researchers began noticing that it also appeared to decrease a healthy person’s chance of contracting the virus. Yesterday the U.S. Food and Drug Administration announced that Truvada’s manufacturer Gilead Sciences Inc. can now market the pill for preventative use.
First the bad news: Doctors have long awaited a prevention method that could break the U.S.’s fifteen year stagnancy at around 50,000 new HIV infections annually. I don’t think Truvada is it.
At $13,000 for a year of daily doses, and doubt over insurance coverage, the drug remains out of reach for most Americans.
The good news: Trials have shown that proper dosage of the pill can reduce the chance a heterosexual person with an infected partner will become infected by 75%. That’s a boon for HIV-free women hoping to become pregnant by an HIV-positive spouse or boyfriend. The pill also reduces infection among condom-using healthy gay and bisexual men by 42%.
Since Truvada’s not a 100% effective HIV vaccine, and it’s got that hefty price tag, who should bother to take it?
NPR’s Richard Knox talked with HIV pill researcher Dr. Kenneth Mayer of the Fenway Community Health Center in Boston. Mayer said it’s exceedingly rare for people in stable relationships to be infected with HIV by their partner. For those already taking precautions in relationships where one person is infected with HIV, Truvada could provide just one extra dose of security.
However, Mayer says it would be more important to get Truvada to men and women who have a much higher risk of infection. They might live in places like Washington, D.C., where men have a one-in-17 chance of getting infected and thus are at risk of infecting their partners.
For women in partnerships with such non-monogamous men, Truvada could grant them control over their infection status that they previously lacked.
One concern people have had over preventative HIV drugs is that they will give users a false sense of security, making them less cautious around sex. However, FDA studies show that taking Truvada didn’t make people any less likely to use a condom.
My biggest question remains how doctors will get the drug to those highest-need populations, instead of just the few wealthy couples who can afford it.
Photo: Erin Kelly/Flickr