The effectiveness of the tenofovir and emtricitabine combination is hard to overstate. Other studies show almost 100% prevention of infection; to my knowledge there have only been two recorded infections in people who were reliably taking PReP, both of which were due to unusual, rare mutations.<p>This sort of thing is a step change for vulnerable populations; hopefully it ends up being widely accessible. The combination of this and aggressive testing and treatment reigimes means that there’s a real possibility of getting close to zero new HIV infections in Western countries.
Since April 1 2018, PrEP is subsidised by Australia under the Pharmaceutical Benefits Scheme (PBS). Thus, it costs $39.5 per script ($6.40 concessional rate) [0, 1]. Earlier, it could cost as high as $10,000 a year [2].<p>[0] <a href="https://www.healthdirect.gov.au/blog/Anti-HIV-drug-PrEP-to-be-added-to-the-PBS" rel="nofollow">https://www.healthdirect.gov.au/blog/Anti-HIV-drug-PrEP-to-b...</a><p>[1] <a href="https://www.healthdirect.gov.au/pharmaceutical-benefits-scheme-pbs" rel="nofollow">https://www.healthdirect.gov.au/pharmaceutical-benefits-sche...</a><p>[2] <a href="https://www.theguardian.com/australia-news/2018/feb/08/hiv-prevention-drug-prep-likely-to-be-approved-for-federal-subsidy" rel="nofollow">https://www.theguardian.com/australia-news/2018/feb/08/hiv-p...</a>
For me the biggest surprise in the article is that there are 180,000 men in the United States on Prep. Given a back of the envelope calculation of 4.8m out gay men in America (3% of population) that means adoption is itself around 3%.<p>Somehow I imagined truvada was more widey adopted but perhaps it is just heavily marketed on the east coast.
Interesting problem we're dealing with: Truvada potentially makes it harder to identify HIV+ blood donors (as their antibody titers fall naturally over time) and raises the question of whether HIV+ individuals will be more likely to attempt to donate in order to "prove they're safe". It is a well-known fact in their community that men having sex with men are deferred from being blood donors for 12 months from last male intercourse, and there is at least a vocal minority in the community which feels this is unjust. Presently, there is no approved question for the donor questionnairre along the lines of "Are you using Truvada?" but it is a hotly debated topic among blood bankers.
And yet STD rates are skyrocketing in the US. I take Truvada but it’s used as an excuse in the gay commmunity to engage in unprotected sex. If anything the availability of Truvada is probably a leading cause of why STD rates in the gay community are increasing.
Honest question. The generics of Truvada are available in India for around USD$30 a bottle from a number of local Indian Pharma companies including Cipla. It would still be cheaper for Americans to travel to India on a budget flight and buy back a year's supply of these generics. Wouldn't US immigration allow importation of small amounts of medicine for personnel usage if you have a doctor's prescription?<p><a href="https://dir.indiamart.com/search.mp?ss=tenvir-EM" rel="nofollow">https://dir.indiamart.com/search.mp?ss=tenvir-EM</a>
From what I've read previously, this isn't a surprise - PrEP is expected to make a huge impact where it's available and this study sounds like it could be very influential in getting it made available elsewhere which is, I think, its real value - the public health effect rather than the individual-level effect.<p>The article linked below also details some of the pitfalls campaigners had to overcome to get it funded on the NHS in the UK - the biggest hurdle was not convincing people of effectiveness but that there was a need in the first place - as safer sex is much cheaper but in practice just doesn't always happen and we're probably at, or close to, the limit of what education can achieve now.<p><a href="https://www.bbc.co.uk/news/stories-44606711" rel="nofollow">https://www.bbc.co.uk/news/stories-44606711</a>
Corroboration from a more reliable news source than Bloomberg: <a href="https://m.indiatimes.com/health/buzz/this-blue-pill-has-been-proving-to-halt-the-spread-hiv-in-its-tracks-355092.html" rel="nofollow">https://m.indiatimes.com/health/buzz/this-blue-pill-has-been...</a>