Amazing HIV Prevention Drug “Truvada” FDA APPROVED! (UPDATE!)

UPDATE JULY 2012: Just before the start of this year’s International AIDS Conference in Washington, DC, the FDA approved a major game-changing drug called “Truvada“. While I’ll let you read my article below from 2010 on the details of the drug’s history I’ll summarize by saying it’s a medication established by “a three-year study f[inding] that daily doses cut the risk of infection in healthy gay and bisexual men by 42 percent, when accompanied by condoms and counseling. Last year, another study found that Truvada reduced by 75 percent the rate at which an HIV-infected person in a heterosexual relationship passed the virus to his or her partner.”

Basically, it works to prevent the passing of HIV. There was a LOT of flack surrounding these studies and attempts to approve the drug as people argued the acceptance of this drug would lead to a reliance on it as the sole source of STD prevention by its users. However, Dr. Debra Birnkrant- FDA’s director of antiviral products (who does not work for Truvada!)- found that subjects in clinical trials in fact increased in condom usage and that STD rates either stayed at a baseline or decreased… basically, users of Truvada didn’t consider it a panacea to replace the ever important condom. THAT SAID, the pill is a daily one and repeated missed doses do reverse the preventative benefits of taking it. Further the cost attached to this puppy is set at about $1,200 a month (woof but it IS a new drug after all) and can cause side effects like diarrhea, kidney and bone damage. My two cents: it’s amazing we’re continuing to battle this disease and any new and effective drug is a step in the right direction. Most importantly, I’m hopeful for monogamous and discordant couples wherein one partner is positive and the other is negative who can possibly add this drug to their regimen to foster some- though of course not total- relief regarding their health and sexual practices. Go science, go FDA and thanks to my handsome Brazillian friend from down South for making sure this got its due coverage.

Huge Breakthrough.
A recent study on a drug called Truvada has been found to significantly cut the odds of infection in gay and bisexual men who engage in what we so euphemistically call “risky sexual practices”… we’re talking a level of protection of 73% for those taking it daily. SEVENTY THREE PER CENT. By no means is Truvada the new condom or the be-all-end-all of discoveries but this is an undeniably huge discovery in the world of HIV prevention for men who sleep with men.

The international study comprised of 2,500 men in six different countries (Brazil, Ecuador, Peru, South Africa, Thailand and the United States) and compared the HIV contraction rates of gay men who self-reportedly had sex with multiple partners and were inconsistent with their condom use: basically, Johnny-Q-Gay. Half the subjects were given a placebo and the other half the pre-exposure prophylaxis (PrEP): Truvada, and there were clear results. After just one year, 64 out of 1,248 placebo participants had contracted HIV while only 36 out of 1,251 of those taking Truvada did. Only a year in, the results have been published in the New England Journal of Medicine as a boon for the current HIV/AIDS epidemic.

Where antiretroviral drugs have been typically seen as a means of preventing the progression of HIV to AIDS and to dampen the infection, Truvada is proving to be a shockingly effective tool in preventing the contraction of the virus: essentially stopping the disease before it even starts. The lead researcher of the study- a Dr. Robert Grant of the Gladstone Institute of Virology and Immunology in California- supported his finding by explaining that instead of just handing out the drugs (or placebos) to the subjects and letting them run wild, they were offered state of the art prevention methods including testing, counseling and education to ensure a balance between the studied men. Basically, where one might argue the seemingly not huge difference in the numbers of those transmitting the disease could be due to something as random as maturity or knowledge on the subject etc., the study truly attempted to equate the random men as thoroughly as possible to ensure the results reflected the role of the drug.

Still, the drug isn’t perfect. As with most medication it requires consistent use: once a day. While we might roll our eyes at the thought of a daily pill being simple to remember, detractors of the study argue that: “Men who engage in ‘risky sexual behavior’ are less likely to be regular with their dosage.” Personally, I’m a bit offended by the assumption that one equates to the other, but it is a relevant issue that the pill must be taken every day. Though, the drug was still found to be at its most effective so long as the regularity of consumption was at least 90% of the time… that sounds safer than birth control to me, but what the hell do I know 😉

Furthermore- and this might not immediately seem like a huge downfall to us mo’s– the drug has only been tested thus far on men who sleep with men. Heterosexual testing and testing with women is still pending so this is not a panacea thus far. This “PrEP research” as it’s being called, has received a huge boost by these results and will hopefully- according to the U.S. Centers for Disease Control- be used to find an effective and indiscriminating tool to battle this global epidemic. Finally, the researchers make it very clear Truvada is not a prevention tool for any other form of STDs: this one affects HIV transmission only.

Personally, this news is pretty amazing. Constantly working to support and donating to HIV/AIDS research causes often seems fruitless as the disease continues on into nearly its 30th year with still 7,000 people a day contracting HIV. So, when something comes along that shakes up the playing field this vigorously, I get pretty excited. Though I’m one of those die-hard condom boys that has never tricked a guy into dating me long enough that the talk of going without has even come up ethereally, the idea that there’s a drug that need only be swallowed with a bit of water daily that will even more greatly increase my likelihood to stay negative is a life-changing one. Clearly, the side effects need to be fully considered- not mentioned if there are any at all in the research I did- and the availability isn’t exactly at your local pharmacy today, but in the future, this is definitely a discovery that’s going to change the way we think about this virus. Go Science!

  • Dan Bate

    Great article Adam. Sad to think that even though participants in the study were probably more educated than most about infection, 4% still contracted it. Much better odds than without, but still.

  • Thanks Dan!
    Good point, regardless of being placebo or no, these guys did have a large amount of knowledge, support and info about this issue and still as many as 4% contracted… “Complicated” doesn’t even begin to describe this issue!

  • Colby

    That’s a really cool new development! And very exciting. Although, one wonders whether a development like this encourages risk-taking, as in “hey I’m on ‘the pill’, I don’t need no stinkin’ condoms!”, in the same way many fear today that HIV/AIDS’ current status as an arguably-manageable disease (rather than the death sentence it was at first) creates a climate of carelessness and encourages risk-taking.

    Obviously, anything that reduces the rate of transmission is an amazing development, but only if it doesn’t concurrently change people’s mindsets in a way that increases risky behaviour and therefore transmission, thus neutralizing any gains…or reductions, maybe.

    Was that part of the study? Maybe there should have been a third control group. It’s entirely possible that the rate of transmission in the placebo group might also have increased due to a change in behaviour, i.e. increased risk-taking based on a perceived level of protection.

    And once-a-day, every-day can be onerous. I can’t even remember to take my multi-vitamin every morning, for God’s sake.

  • Somehow, I would like to think if it was a pill you were expecting to help prevent contraction of HIV you’d take it a bit more serious than a multivitamin… maybe go as crazy as put an alarm on your iPhone to remind..?
    Personally, I see that kind of argument akin to teaching abstinence rather than proper condom use because “teaching of the benefits of condoms makes kids think it’s okay to just have sex with anyone etc”. I doubt someone with even half a brain who WANT to stay negative will say “hey, 73% chance i won’t get it? who needs a condom/to ask about their status”… 73% isn’t exactly a for sure deal by ANY means.

  • Colby

    Oh, I disagree strongly, Adam. The groups were gay men who were laissez-faire with condom use already (or as you call them, Johnny-Q Gay), so already taking pretty serious chances. You think that’s a group that’s going to go “oh my God I have to take my once-a-day-73%-chance-of-stopping-the-transmission-of-HIV pill!!!! Stop everything!”. No, they’re going to go “meh, I’ll take it tomorrow. Maybe. I’m sure it’s fine.”

    And I think you’re reaching by comparing it to teaching abstinence as THE effective means of preventing transmission. Abstinence is unrealistic. Condom use isn’t. Just ask…oh, I don’t know…YOU!

  • Hmmmm I think we’re gonna have to agree to disa…. nah, let’s just both agree you’re wrong colbs.

    First off, the guys were “inconsistent” with condom use. Do you know what constitutes “consistent”? 100% or 0%. And, other than myself, I’ve never met a single person in my life who’s at that 100% mark, and, except for those few die-hard bare backers hititn’ the 0% one hundred percent of the time, every gay male in the middle is taking “pretty serious chances” as you put it… I would argue that not every gay we know is “taking pretty serious chances” with their lives/health… but, that’s just my opinion there, you’re absolutely in your right to judge that they are.

    Second, for the LARGE part, every time i’ve heard of a friend not using a condom it’s been a drunken/drug addled/moment of passion didn’t-want-to stop-it decision right at the moment of penetration: it wasn’t something they sat down and consciously decided with much forethought (setting aside those I know who often and purposefully don’t use condoms that it of course). Taking medicine daily (which typically occurs in the morning before work for most, or at night while brushing teeth etc.) isn’t usually an after-dropping-e-and-finding-one’s-self-in-a-backroom-at-the-Eagle thing to do. Therefore equating the slipping on of a condom mid-fuck to taking medication at ANY point during the 1440 minutes of the day seems a bit spurious, sugar 😉

    Finally, CLEARLY i’m not teaching abstinence as “the” tool to prevent transmition silly. Maybe my thick sarcasm in which I compared your argument to “abstinence preachers” directly AFTER I made fun of your argument wasn’t obvious…? I’ll slow it down for ya: saying that a study which demonstrates Truvada to be a means of REDUCING (note: not eliminating) HIV transmition (by a percent MUCH less than using condoms) means people will say “f-that” to wrapping it up is like saying if a guy heard douching could vaguely decrease the chance of catching the virus he’d run to his drawer and throw out all Trojans and Truvadas. Sure, there’s always those few crazed exceptions out there, but the majority of guys aren’t that insane and without reason: again, though, maybe I just give us more credit.

    …don’t worry, you don’t have to reply if you agree now 😉

  • bruin

    yay adam. you can add me onto your 100% condom. it’s only going off when there’s a ring on my finger. and also, abstinence is unrealistic since we are human beings and sex is as normal as eating, breathing, drinking. great post on the new update!

  • Adam

    I guess I’m not alone then bruin!
    Waiting till a ring eh? Beyonce would be proud: I don’t think I have that patience haha but till a treating and clear commitment is made I’m in the condom boat with ya!
    Thanks for the comment!

  • sam

    Israel has made a breakthrough,, they had got the formula for kiiling the HIV virus gene untouching the un-infected cells,
    hebrew university, Jerusalem

  • Juan

    It’s a mixed bag for me. Anything that can help reduce the Rick of transmission is a step forward! But I disagree that the lack of testing on women isn’t a big deal, it’s got huge implications here in the U.S. and around the world for women whose partners won’t wear condoms. Also Truvada’s been in use by HIV positive folks as combination therapy for years, it’s now being approved for a very different use. And with the health care system in the state that it’s in, it’s doubtful it will be covered by insurance.

  • Juan- You make a really great point and I’m going to scratch out that throw away line. The spirit of it was to keep gay guys’ attention but you’re right, this important revelation and progression needs to be made available and useful for ALL people affected by hiv and aids. Honestly, I was just trying to communicate that it’s amazing for “men who have sex with men” to be finally focused on in scientific research and not just seen as an afterthought.

  • Juan

    Thanks Adam. Keep up the good work on the site.