Whether fearing broken condoms or wishing to avoid latex entirely, positive people and the negative people who love them have plenty of reason to want pre-exposure prophylaxis (PREP), a pill you could pop to prevent HIV infection, to hit shelves. Researchers started testing Viread (tenofovir) as a possible HIV blocker in 1998 and then Truvada (tenofovir and emtricitabine) in 2005. There’s no conclusive proof that either med works as PREP. But is even the possibility spurring unsafe behavior? Last summer, the Centers for Disease Control (CDC) decided to drop by gay pride events in four U.S. cities to see whether buzz about PREP had prompted sexual risk taking. Seven percent of respondents said they had taken antiretrovirals as an HIV preventive at least once.
Preliminary results from a monkey study announced in February suggest that Truvada may block HIV better than Viread, which has received the most extensive PREP testing. The CDC says even if it is approved as a preventive, PREP should not be a solo strategy. Researchers chose to test Viread and Truvada because of their relatively mild side effects, though both (as people with HIV know) can come with headaches, nausea and diarrhea. What’s more, if PREP users do get infected with HIV, they may later be resistant to the meds.
So why are people taking them as PREP? “A large number of people have not seroconverted due to post-exposure prophylactic treatment [PEP], causing speculation about PREP,” says Jason Farrell, executive director of New York’s Positive Health Project. “And there will always be thrill seekers trying to dodge the bullet.” Says one man from Dallas who has sampled PREP, “Even if it’s not 100% effective, I think it’s a smart thing to do. It can counter the ‘stupid factor’ that often governs decision making when it comes to sex.”
Some AIDS advocates worry that researchers and funders might abandon PREP if it’s linked to condomless sex. CDC spokesperson Terry Butler thinks otherwise, adding, “[The survey results] point to the importance of current U.S. trials, which will answer questions about the impact of a daily prevention pill.” So for now, anyway, PREP’s still in session.