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Bottles of anti-HIV drug Truvada are displayed at Jack's Pharmacy on November 23, 2010, in San Anselmo, Calif.
Bottles of anti-HIV drug Truvada are displayed at Jack's Pharmacy on November 23, 2010, in San Anselmo, Calif. Justin Sullivan/Getty Images
In November, researchers revealed a encouraging finding: taking a pill can greatly reduce the risk of getting HIV. Now health officials are warning doctors that preventing the disease will take more than just writing a prescription.
The pill, called Truvada, is already on the market for treating HIV infections. But the landmark study, involving 2,500 men who have sex with men, showed that taking Truvada faithfully can reduce the risk of infection by as much as 92 percent.
That touched off a lot of celebrating. It's the first time anybody's shown that taking a pill can prevent HIV – and it was the first new weapon against HIV unveiled in many years.
To make sure it works, though, the Centers for Disease Control and Prevention says doctors need to do a number of things:
- Prescribe Truvada only for men at high risk of getting infected – that is, only for men who have sex with men, those who have multiple sex partners, and those who live in areas where there's a lot of HIV circulating.
- Test patients before prescribing it to make sure they're not already infected. That'll help avoid creating viruses resistant to the drug when patients miss doses. For the same reason, patients should get an HIV test periodically while on the drug.
- Counsel patients on Truvada to use condoms faithfully, because the drug isn't a sure bet against the virus.
- Above all, tell patients they must take the drug every day – not just when they've had risky sex.
The study makes that last point very clear. Overall, men who took Truvada had a 44 percent lower risk of HIV infection. But those who said they took the drug at least 9 out of every 10 day had a 73 percent lower risk.
That doesn't tell the whole story. When researchers tested the blood of patients for traces of Truvada, they found many who claimed to have taken the pill regularly weren't telling the truth. Among those whose tests showed they really did take it every day, the risk of HIV infection was 92 percent lower than those not on the drug.
There's one other thing, the CDC says. Make sure patients understand that warding off HIV isn't cheap. Each pill currently costs around $36, which adds up to more than $13,000 a year. Some insurers might pay, but some might balk.
And Truvada has side effects. Among the most common are diarrhea,
nausea and fatigue. Less common but very serious reactions are also possible, including a dangerous build up of acid in the blood and liver damage