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The Whole Truth: Your contention that the study only reduced risk by 44% isn't really correct. The 44% figure refers to everyone in the entire study who was offered to take the pill – all 2,499 individuals. Only about half of the participants ACTUALLY TOOK their pills – so the 44% figure is based on the efficacy rate for everyone in the trial – whether they took it or not. For people who actually did take their pills, based on blood detection, their rate of protection was upwards of 90% – as high as 96%. Moral: PrEP works if you take it.
i think Prep is an awesome breakthrough in the history of HIV..Atlast there is Something in the hands of the common man to beat HIV.condoms arent totally foolproof.they can break sometimes.As long as truvada doesnt have side effects,it can be taken by high risk groups like sexworkers and people who have multiple partners and dont take precautions.If you ask me,the best is to have sex only with somebody whom you are sure about..it aint worth taking risks.
I think it is irresponsible to underestimate the potential threat of creating drug resistance strains of HIV through the use of PrEP. Your arguments for why drug resistance is not a problem are not scientifically based and do not address the complexities of personal behavior. If it was easy for people to always act in their best interest HIV would already be under control. It took a long time and far too many lives to develop drugs that are effective against HIV to move forward with an intervention that has too great a potential to put us back where we started.
How many of the authors writing about PrEP are long term survivors? How many of them have taken Tenofavir? What percentage of them have Permanent Kidney Damage from the Tenofavir in the Truvada? I have that permanent kidney damage, as do 5 to 10 percent of the people who take Tenofavir. If you had the damage, maybe you would think twice before recommending PrEP as a viable alternative to using condoms for anal intercourse.
thanks for writing. i've never taken the time to fully investigate the what/how/why surrounding prep but im glad i took the time to read and learn up on this.
I agree that the PrEP debate has been ruled as much by emotion as by facts. That's why it's so disappointing to me that you studiously avoid citing the key finding of the iPrex study. Yes, over 90% protection for those mostly adherent. But for the whole study population, the risk reduction was just 44%. http://www.aidsmap.com/The-iPrEx-study/page/1746640/ True, it's Truvada's not to blame if people simply didn't take their pills. But if we follow that logic, then condoms are perfect, too, as long as you don't count the times people skip using them.
As a 25 year POZ survivor Periferal Neuropathy has made condom use an act of futility. I am in a relationship with a HIV negative partner, Prep is our only option to diminish risks further. My viral load is undetectable, so his risk is low, I have never been on Truvada, even with the direct programs from the manufacturer, he would still have to pay the entire wholesale price, this was prior HCRA.
Mark S. King
Carolyn Lieber: There are too many legitimate concerns about HIV risks without creating fantasy scenarios that don't exist. There is virtually NO risk of HIV resistant strains being created by PrEP. For that to happen, a negative person would have to be missing PrEP doses enough to be vulnerable AND have sex with a poz person who wasn't undetectable AND the poz person was resistant to meds AND the poz person actually infected them. We're talking a millionth chance. AND THEN those same circumstances would have to repeat in order for that strain to continue. Oh my. Run for the hills!
March 23, 2014