Slowing the Spread of HIV

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Imagine living in a community where a third of the people have HIV. In parts of Uganda, Kenya and Botswana, people face that reality daily.

Even though money and resources are being used to educate the public there, social, political and cultural barriers continue to hinder efforts to control the epidemic. That's why scientists around the world have spent years trying yet failing to come up with an HIV vaccine.

A new treatment approach using existing HIV drugs can prevent HIV infection. Studies out of the University of Washington and the Centers for Disease Control show treating uninfected individuals with anti-HIV drugs can prevent HIV infection.

These studies were done on couples where one person is infected with HIV and the other is HIV free. The uninfected partner is given a pill daily, either Tenofovir or Truvada, which combines Tenofovir and emetricitabine.

One study involved 1,219 Botswana couples where half the couples took Truvada and the other half took a placebo. The results showed that nine out of 601 participants taking Truvada contracted HIV during the study period, compared to 24 out of 599 participants taking a placebo. That's a 63 percent reduction in HIV transmission.

In the second study, of the 4,758 couples, one third of the HIV-negative partners took Tenofovir once daily, one third took Truvada once daily, and the remaining third received a placebo. Results showed 18 partners taking Tenofovir became infected, 13 in partners taking Truvada, and 47 among those taking a placebo. That means the infection risk was 62 percent lower for those taking Tenofovir, and 73 percent lower with Truvada.

Additionally, a study of gay male couples taking Truvada showed a 44 percent lower transmission risk. These results are considered successful enough that although the U.S. Food and Drug Administration hasn't approved Truvada for HIV-prevention, the Centers for Disease Control has already issued a guideline for those interested in starting the regimen.

Yet some AIDS groups in the United States are opposed to gay men using the drugs as a preventative, citing the 44 percent success rate as not effective enough because it could lead to riskier sexual practices and possibly create a drug-resistant HIV.

What's clear now is Truvada and Tenofovir have the ability to make a tremendous impact on communities in sub-Saharan Africa, an area with nearly 70 percent of the world's HIV cases. Since the side effects of these drugs are few, it will be easier to convince people not only to take them daily but to continue for the foreseeable future.

More Information

Anti-HIV Pills Powerfully Protect Uninfected Heterosexuals
A layman-friendly article from Science Magazine detailing the studies mentioned in this week's column.

CDC Trial and Another Major Study Find PrEP Can Reduce Risk of HIV Infection among Heterosexuals
CDC press release announcing preliminary results from the two studies on oral antiretroviral drugs administered prior to infection.

Two Studies Show Pills Can Prevent H.I.V. Infection
Another easy-reading article, this one from the New York Times, looks at these study results.