Antiretroviral Drugs May Prevent HIV Infection
Studies Show Once-Daily Pill May Cut HIV Infection Risk by up to 73%
Applying the Study Findings to the U.S.
Independent experts said that while the study results appear to be very promising, it was unclear how they might translate to people in the U.S.
Bruce Hirsch, MD, attending physician of infectious disease at North Shore LIJ Health System in New York said most of his HIV-positive patients in committed relationships were already taking substantial precautions to avoid passing the virus on to their partners.
Those precautions include using condoms and taking antiretroviral medications, like the ones used in these studies.
When those drugs are taken by HIV-infected people, they can reduce the risk of transmission to uninfected partners by 97%, Hirsch says.
"I think of a person who would use this medication as a person who is not in a committed relationship, who is maybe an unusual combination of being responsible and not so responsible, who wants to make unsafe sex a little safer," Hirsch says.
"It's a little bit hard for me to conceive of a person so thoughtful and so health conscious that he or she would take this step but not use barrier precautions," Hirsch says.
It's also unclear whether insurance would pick up the tab when the drugs are used in healthy people. By some estimates, Truvada costs between $12,000 and $14,000 a year in the U.S.
"There are two key issues here: Who will have access to the drugs, and how do you decide distribution?" says Sandra I. McCoy, MPH, PhD, an epidemiologist at the University of California, Berkeley. "We have many resource-poor settings where treatment is not available to everyone who needs it already. That will be the next focus area of research, these implementation kind of questions."
According to a 2008 report from the CDC, 86% of new HIV cases in the U.S. were attributed to sexual transmission, 54% among men who had sex with men and 32% among heterosexual partners.
"It's nice to know that there are other means of preventing HIV," Hirsch says. "HIV is treatable, but still, getting HIV is a personal tragedy and any means to prevent this infection is important for us to know about."