Study: AIDS pill helps gay men avoid HIV infection

[knight_shadow]

Scientists have an exciting breakthrough in the fight against AIDS. A pill already used to treat HIV infection turns out to be a powerful weapon in protecting healthy gay men from catching the virus, a global study found.

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services. Men who took their pills most faithfully had even more protection, up to 73 percent.

Researchers had feared the pills might give a false sense of security and make men less likely to use condoms or to limit their partners, but the opposite happened — risky sex declined.

The results are "a major advance" that can help curb the epidemic in gay men, said Dr. Kevin Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and Prevention. But he warned they may not apply to people exposed to HIV through male-female sex, drug use or other ways. Studies in those groups are under way now.

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I really want to know how this works. The article says it's a major advance for gay/bisexual men, but would not apply to M-F couples and needle users. What exactly is this pill doing?

[jennyj87]

I'm confused on how it would not work for m-f couples?

[agzg]

Originally Posted by knight_shadow

link

I really want to know how this works. The article says it's a major advance for gay/bisexual men, but would not apply to M-F couples and needle users. What exactly is this pill doing?

Hmmm perhaps due to the method of transmission?

Unless they're deciding that "ZOMG teh gay" is some sort of genetic defect here (oh my that will go oh so well).

[Drolefille]

Originally Posted by knight_shadow

link

I really want to know how this works. The article says it's a major advance for gay/bisexual men, but would not apply to M-F couples and needle users. What exactly is this pill doing?

AFAIK it's because it hasn't been tested on them. Later they say that they've used HIV treatment to prevent infection before in pregnant women and people inadvertently exposed to infected bodily fluid like hospital employees pricked by an improperly disposed of sharp.

It's a bit like the HPV vaccine not being available for men despite the fact that it would work just fine in them.

[knight_shadow]

Originally Posted by agzg

Hmmm perhaps due to the method of transmission?

I can see that with IV drug users, but not with M-F couples.

Originally Posted by Drolefille

AFAIK it's because it hasn't been tested on them. Later they say that they've used HIV treatment to prevent infection before in pregnant women and people inadvertently exposed to infected bodily fluid like hospital employees pricked by an improperly disposed of sharp.

It's a bit like the HPV vaccine not being available for men despite the fact that it would work just fine in them.

That makes sense, but I still want to know what kind of pill would be useful for one orientation but not another. It's not as if the virus can detect whether or not someone is a homosexual, you know?

I'd be interested in seeing the remaining studies when they're completed.

[Drolefille]

Originally Posted by knight_shadow

I can see that with IV drug users, but not with M-F couples.



That makes sense, but I still want to know what kind of pill would be useful for one orientation but not another. It's not as if the virus can detect whether or not someone is a homosexual, you know?

I'd be interested in seeing the remaining studies when they're completed.

But the transmission is slightly different as it's usually due to anal sex. It's much harder for men and women to get the virus via PiV sex.

So that's why it didn't necessarily say straight couples, but M-F couples. It's not the orientation that matters but the transmission vector.

[IrishLake]

I think it's just saying they are studying the effects on M-F partners and needle users, and don't have a conclusion yet. But they did the study on gay men first, and have a result. Could be the pill "may" work for needle users and M-F partners as well, they just can't say yet. Note it's not a miracle pill, but most effective when coupled with condoms, counseling, etc.

I think this is disturbing. "As a practical matter, price could limit use. The pills cost from $5,000 to $14,000 a year in the United States, but only 39 cents a day in some poor countries where they are sold in generic form."

[knight_shadow]

Originally Posted by Drolefille

But the transmission is slightly different as it's usually due to anal sex. It's much harder for men and women to get the virus via PiV sex.

So that's why it didn't necessarily say straight couples, but M-F couples. It's not the orientation that matters but the transmission vector.

Got it. Thanks for the extra info.

[IrishLake]

Originally Posted by Drolefille

But the transmission is slightly different as it's usually due to anal sex. It's much harder for men and women to get the virus via PiV sex.

So that's why it didn't necessarily say straight couples, but M-F couples. It's not the orientation that matters but the transmission vector.

Yes. This.

[DrPhil]

This is the most important part of the study:

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services.

In other words, don't follow the white rabbit down the hole and think there's now a pill that says it's okay to carelessly go raw dawg and drop loads in 'em. That goes for all anal couples (gay and hetero). Mmmmkay!? Thanks.

[Drolefille]

Originally Posted by knight_shadow

Got it. Thanks for the extra info.

I feel compelled to clarify that "much harder" doesn't really mean incredibly difficult, just that there are less likely to be entries into the bloodstream at any given time.


And honestly between the cost - no insurance company will pay for this as a long term preventative - and the overall lack of reliability, I don't see this getting used except as a 'morning after' pill should people find out their partner is positive following sex.

It's good that the pill is so much cheaper outside of the US, but it's probably needed far more for treatment there. And particularly women in those countries are the most vulnerable, so more testing needs to be done to give them access.

[knight_shadow]

Originally Posted by IrishLake

I think it's just saying they are studying the effects on M-F partners and needle users, and don't have a conclusion yet. But they did the study on gay men first, and have a result. Could be the pill "may" work for needle users and M-F partners as well, they just can't say yet. Note it's not a miracle pill, but most effective when coupled with condoms, counseling, etc.

I think this is disturbing. "As a practical matter, price could limit use. The pills cost from $5,000 to $14,000 a year in the United States, but only 39 cents a day in some poor countries where they are sold in generic form."

Yea, I get that it's still being tested. I was just trying to wrap my mind around what the pill itself does. It goes without saying that it needs to be coupled with other protective measures, but I'm just trying to figure out what the pill is doing for it to work in gay/bisexual men but possibly not in M-F couples.

Ex. If it's attacking the virus, that shouldn't be exclusive to one orientation group (I know this isn't the case, since this is to be a preventative measure, but that's what my thought process is).

[DrPhil]

I don't think a whole lot of people will use the pill, either because of lack of access or perceived lack of effectiveness.

Unfortunately, I do think that some people will take this to mean that there are "quick fix" preventive measures and perhaps even a "cure" down the road. That can lead to carelessness because humans tend to be careless when they believe something may become foolproof.

[KSig RC]

Originally Posted by Drolefille

AFAIK it's because it hasn't been tested on them.

Yep - we should all remember that you have to be REALLY careful publishing results, particularly before peer review. If it were only tested in a certain area, that's all we can say (even if it likely has effects in other areas).

We should also remember that peer review "reverses" a relatively large number of niche findings like this.

Originally Posted by DrPhil

This is the most important part of the study:

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services.

In other words, don't follow the white rabbit down the hole and think there's now a pill that says it's okay to carelessly go raw dawg and drop loads in 'em. That goes for all anal couples (gay and hetero). Mmmmkay!? Thanks.

Also important to keep in mind - causation/correlation and all that.

Viruses are still one of the greatest challenges to human health, even though we've made exponential improvements just in the last decade or so. It's really encouraging, though, that treatments are being proven effective and finding new (and equally vital) uses. Now, if the cost could come down, we'd be in business.

[knight_shadow]

Originally Posted by DrPhil

This is the most important part of the study:

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services.

In other words, don't follow the white rabbit down the hole and think there's now a pill that says it's okay to carelessly go raw dawg and drop loads in 'em. That goes for all anal couples (gay and hetero). Mmmmkay!? Thanks.

I appreciate the visual this early in the afternoon lol

Originally Posted by Drolefille

I feel compelled to clarify that "much harder" doesn't really mean incredibly difficult, just that there are less likely to be entries into the bloodstream at any given time.

Understood. I inadvertently used M-F to mean "straight" in my mind. I get that there's a higher risk because of the way intercourse takes place.