HIV Prevention Pill A Big Development In Communities Of Color

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A new study by the National Institutes of Health suggests that a pill, known as Truvada, may be able to prevent HIV infection for gay and bisexual men. Host Allison Keyes talks with Dr. Jonathan Mermin of the Centers for Disease Control and Adolph Falcon of the National Alliance for Hispanic Health about the drug and what it could mean for communities of color which are disproportionately impacted by HIV/AIDS in the US.

ALLISON KEYES, host:

I'm Allison Keyes and this is TELL ME MORE from NPR News. Michel Martin is away.

In just a few minutes, we'll talk to a Zambian AIDS activist about an apparently stunning change of course for the Vatican. What does the Pope's newly expressed thinking on condoms mean to the HIV/AIDS crisis in Africa, where the Catholic Church holds such sway?

But, first, we go to a possible breakthrough in HIV research. A National Institutes of Health study suggests that a drug called Truvada can help prevent HIV infection for gay and bisexual men. It's the first indication of an oral drug that can provide protection against HIV infection.

To tell us more about the new study and what it means for people concerned about contracting the HIV virus, we're joined by Dr. Jonathan Mermin from the Centers for Disease Control. He's on the phone from Atlanta. And here in studio is Adolph Falcon of the National Alliance for Hispanic Health. Thank you, gentlemen, for joining us.

Dr. JONATHAN MERMIN (Centers for Disease Control): It's good to be here.

KEYES: Dr. Mermin, let me ask you first, what exactly did the study find about Truvada?

Dr. MERMIN: Well, the results from the study do represent a major advance. It's the first firm evidence we have that taking a drug can prevent people from getting HIV. In this case, reducing risk by 44 percent. And this is particularly welcome news since the study enrolled participants from one of the hardest hit groups: gay and bisexual men, among whom half of new HIV infections in the U.S. are occurring.

KEYES: Mr. Falcon, the U.N. announced this week that the global HIV pandemic is slowing. New cases have dropped almost 20 percent in the last decade. But there's already kind of a sense in the community that HIV is, you know, it's treatable now. It's not the death sentence that it used to be. Do you think that this drug is another step in people thinking that HIV is a manageable disease now?

Mr. ADOLPH FALCON (National Alliance for Hispanic Health): Well, I think one of the concerns is calling this the prevention pill might lead people to believe that there is something out there that is a cure. A prevention pill is really a misnomer for this. This is a prevention sometimes pill. You know, the study found that it worked about half the time. That's not a great number, you know.

I think the message needs to be really loud and clear from those of us in the public health community that the first line of defense remains safer sex.

KEYES: And people in the Latino and African-American community are much more at risk for HIV than the rest of the population, are they not?

Mr. FALCON: That's true. There's higher rates of new infections among both Hispanics and among African-Americans. The rates of new infections, for example, for Hispanic men are about twice those for non-Hispanic whites. And they're significantly higher, about six times, for non-Hispanic blacks.

So, those of us who have been working in this field almost have a little bit of a fatigue in not having had something new in the arsenal to help treat the rates of infections. And we're happy to have something new. But I think it's important to understand that while this may be something new, it's also not the first line of defense and we need to continue with our message of safer sex.

KEYES: Dr. Mermin, it's interesting that he just said arsenal because I seem to think that part of the studies show that Truvada needs to be used in conjuction with regular testing and counseling and using condoms. If you don't do all those other things, is this pill still going to be as effective as it seems to be in the study?

Dr. MERMIN: Well, it's true that it's not time for people to throw away their condoms. All of the participants in the study did receive intensive behavioral interventions, HIV testing and diagnosis and treatment for sexually transmitted diseases.

And so when we think about how effective this might be in the real world, we have to deal with the questions of - will people be able to take a drug every day? Will they continue to use other prevention intervention, such as condoms and risk behavior reductions and HIV testing?

And will we collectively be able to overcome the financial and operational barriers that will enable equal access to what is a costly and intensive intervention? Currently, the cost for a year supply of Truvada in the U.S. is over $10,000.

KEYES: Mr. Falcon, we were just speaking about the cost of the drug. That's going to be a little steep for low income communities, $36 a day?

Mr. FALCON: Well, the cost is a major concern and that's really why you have to look at this in terms of what are your best expenditures for prevention? For us, saving a life is priceless. But when you really look at the cost, I think one of the things that's getting missed in this study is the fact that the participants had such intensive prevention counseling.

Every month they had HIV testing. They had free condoms provided. They had regular counseling and they had management of other sexually transmitted diseases. And our HIV budget in this country, we just don't have those kinds of funds to provide that kind of intensive prevention counseling for everybody that needs it.

And I think that's really one of the kind of missing big lessons that came out of this study, is that prevention and counseling works. And we really should be ramping up our funding of that.

KEYES: Dr. Mermin, is there any thought that insurance would cover this for healthy people? I know that so far it covers for people that already suffering, but what if people are using it as a preventive measure?

Dr. MERMIN: We don't know. But we do believe that effective prevention interventions, including this one, should be available to all of those Americans who need them. So we need to collaboratively bring together all the key players from the public and private sector to try to ensure that this drug is affordable and accessible to all of those at very high risk for HIV infection.

KEYES: We're going to have to leave it there, gentlemen. Dr. Jonathan Mermin is director of the division of HIV/AIDS prevention for the CDC. He spoke to us by phone from rainy Atlanta, Georgia.

Adolph Falcon is senior vice president for the National Alliance for Hispanic Health. And he joined me here in our Washington, D.C. studios. Thank you, gentlemen, so much for joining us, and happy holidays.

Dr. MERMIN: Thank you very much.

Mr. FALCON: Happy holidays.

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