DEC 01, 2015 8:05 PM PST

PrEP'ing Both Sides of the Other Little Blue Pill

WRITTEN BY: Xuan Pham
Truvuda, also known as PrEP, is a little blue pill that is the only FDA approved drug for prophylactic prevention against the Human Immunodeficiency Virus (HIV). For people at risk of contracting HIV by sex, taking the drug as pre-exposure prophylaxis (PrEP) could decrease the risk by as much as 90%. But with so much promise, this drug still stirs up many debates on its use as a preventative measure. In light of World AIDS day, a recent report took a look at both sides of this little blue pill.
 
PrEP stirs up HIV debate

PrEP is a combination of two antiretroviral drugs, tenofovir and emtricitabine, that prevent HIV by blocking the key viral enzyme reverse transcriptase. Without this enzyme, the virus can’t replicate itself and transmission is significantly reduced. While studies differ in the exact quantification of the drug’s efficacy, it’s clear that the drug is highly effective against HIV infection.
 
Proponents of the pill include the Centers for Disease Control and Prevention, who report that, “People at high risk who should be offered PrEP include about 1 in 4 sexually active gay and bisexual men, 1 in 5 people who inject drugs and 1 in 200 sexually active heterosexual adults.”
 
In addition, advocates of PrEP argue that the drug relieves the psychological burden of HIV transmission during sexual intimacy. Sarit Golub, an expert on the psychological effects of PrEP, reported that patients under treatment noted a dramatic reduction in anxiety, depression, and stress.
 
On the other hand, condoms are 98% effective against transmission of sexually transmitted diseases, including HIV. This form of prophylaxis is also much more affordable than PrEP, which can cost as much as $1,500 per month without insurance. In addition, opponents of the drug are quick to remind people that PrEP is a drug that comes with side effects, including gastrointestinal issues, fatigue, headaches and mild itching or skin rash. More serious health effects could include kidney and liver problems, warranting quarterly blood tests to monitor organ functions.
 
Furthermore, opponents of PrEP fear that the drug could encourage a false sense of safety. The drug works by daily oral pills, but “the record of people taking pills for every disease is bad,” says Michael Weinstein, AIDS Healthcare Foundation President. Furthermore, Weinstein believes that the pill will erode “condom culture,” whereby people who are on PrEP forgo condoms and put themselves at risk for other diseases like syphilis and gonorrhea.
 
While there are benefits and disadvantages to Truvuda, the debate over this little blue pill shines the spotlight to a very serious health crisis that is the HIV/AIDS epidemic. Ultimately, patients and their doctors are responsible for choosing the prevention method that’s most appropriate to their lifestyle. And that may mean condoms, PrEP, or both. 
 

Source: CNN, Truvuda
About the Author
I am a human geneticist, passionate about telling stories to make science more engaging and approachable. Find more of my writing at the Hopkins BioMedical Odyssey blog and at TheGeneTwist.com.
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