A Blue Pill Is Stopping HIV, World-First Study Shows

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.

Developed by Gilead, the same company that created the Hep-C cure Sovaldi. Some kick-ass work there.

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:&#x2F;&#x2F;www.healthdirect.gov.au&#x2F;blog&#x2F;Anti-HIV-drug-PrEP-to-be-added-to-the-PBS" rel="nofollow">https:&#x2F;&#x2F;www.healthdirect.gov.au&#x2F;blog&#x2F;Anti-HIV-drug-PrEP-to-b...</a><p>[1] <a href="https:&#x2F;&#x2F;www.healthdirect.gov.au&#x2F;pharmaceutical-benefits-scheme-pbs" rel="nofollow">https:&#x2F;&#x2F;www.healthdirect.gov.au&#x2F;pharmaceutical-benefits-sche...</a><p>[2] <a href="https:&#x2F;&#x2F;www.theguardian.com&#x2F;australia-news&#x2F;2018&#x2F;feb&#x2F;08&#x2F;hiv-prevention-drug-prep-likely-to-be-approved-for-federal-subsidy" rel="nofollow">https:&#x2F;&#x2F;www.theguardian.com&#x2F;australia-news&#x2F;2018&#x2F;feb&#x2F;08&#x2F;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.

Graph seems to be comparing 6 months of 2018 with full years before that which would vastly overstate the decline.

Interesting problem we&#x27;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 &quot;prove they&#x27;re safe&quot;. 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 &quot;Are you using Truvada?&quot; 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&#x27;s supply of these generics. Wouldn&#x27;t US immigration allow importation of small amounts of medicine for personnel usage if you have a doctor&#x27;s prescription?<p><a href="https:&#x2F;&#x2F;dir.indiamart.com&#x2F;search.mp?ss=tenvir-EM" rel="nofollow">https:&#x2F;&#x2F;dir.indiamart.com&#x2F;search.mp?ss=tenvir-EM</a>

From what I&#x27;ve read previously, this isn&#x27;t a surprise - PrEP is expected to make a huge impact where it&#x27;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&#x27;t always happen and we&#x27;re probably at, or close to, the limit of what education can achieve now.<p><a href="https:&#x2F;&#x2F;www.bbc.co.uk&#x2F;news&#x2F;stories-44606711" rel="nofollow">https:&#x2F;&#x2F;www.bbc.co.uk&#x2F;news&#x2F;stories-44606711</a>

Corroboration from a more reliable news source than Bloomberg: <a href="https:&#x2F;&#x2F;m.indiatimes.com&#x2F;health&#x2F;buzz&#x2F;this-blue-pill-has-been-proving-to-halt-the-spread-hiv-in-its-tracks-355092.html" rel="nofollow">https:&#x2F;&#x2F;m.indiatimes.com&#x2F;health&#x2F;buzz&#x2F;this-blue-pill-has-been...</a>