Drugs May Prevent HIV Spread Among Heterosexuals
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Preventive treatment might keep uninfected partners from getting the AIDS-causing virus, studies show.
WEDNESDAY, July 13 (HealthDay News) — Giving antiretroviral drugs to heterosexuals at high risk of HIV infection can significantly reduce the chance they will develop the AIDS-causing virus, two new studies suggest.
"This is an extremely exciting finding for the field of HIV prevention," said Dr. Jared Baeten, co-chair of one study and a University of Washington associate professor of global health.
Both trials were done in Africa. In one, a daily dose of Truvada, a combination pill that includes tenofovir disoproxil fumarate and emtricitabine, reduced the risk of getting HIV from infected partners by about 63 percent.
The other study found that two different regimens — tenofovir, sold as Viread, and Truvada — also reduced the risk of transmission through heterosexual sex.
Using antiretrovirals in this way is called pre-exposure prophylaxis, or PrEP.
Earlier research found that PrEP reduced HIV transmission among gay and bisexual men, but whether it could prevent HIV infection among heterosexuals was unknown.
A subsequent trial, reported in May, that involved heterosexuals found that people with HIV could reduce the risk of infecting their sex partners by more than 90 percent if they started treatment with antiretroviral drugs when their immune system was still relatively healthy.
The latest research includes a trial conducted by the U.S. Centers for Disease Control and Prevention (CDC) and the Botswana Ministry of Health. For that study, researchers assigned 1,219 HIV-negative men and women to a daily dose of Truvada or a dummy pill. All the participants also received HIV prevention services, including condoms, risk-reduction counseling and testing and treatment for sexually transmitted diseases, according to the CDC.
Nine of those taking Truvada became HIV-positive, compared with 24 of those taking the placebo. That is a 62.6 percent reduced risk for those on Truvada, the researchers said.
Among those who continued taking the pill, the risk reduction was greater — 77.9 percent.
No significant safety concerns were associated with Truvada, the study said, although people taking it were more likely to report nausea, vomiting and dizziness than those taking placebo.
The other new trial, called the Partners PrEP study, was headed up by the University of Washington and funded by the Bill & Melinda Gates Foundation. The placebo portion of the study was halted sooner than expected because early findings so strongly indicated that the pill prevented the spread of HIV. That led to the CDC releasing the results of its study early as well, on Wednesday.
The Partners PrEP trial, done in Kenya and Uganda, included 4,758 couples with one partner who was HIV-positive. Individuals without HIV were randomly assigned to a single drug (Viread), a drug combination (Truvada) or a placebo.
As of late May, 78 HIV infections had occurred; 18 of them in the Viread group, 13 taking Truvada, and 47 who took the dummy pill.
For those getting Viread, the single drug, the risk of developing HIV was reduced 62 percent, while the two-drug combination reduced the risk 73 percent compared with placebo, the researchers said.
"Now, more than ever, the priority for HIV prevention research must be on how to deliver successful prevention strategies, like PrEP, to populations in greatest need," said Baeten in the statement.
Truvada is approved by the U.S. Food and Drug Administration for use in combination with other antiretroviral agents to treat HIV-1 infection in adults and children 12 and older. It has not been approved for PrEP.
Based on the new study results, the CDC will start working to develop guidance on the use of PrEP among heterosexuals in the United States, the agency said.
"To use PrEP in the United States we would use basically the same guidelines – someone who is truly at risk for HIV," said Dr. Margaret A. Fischl, professor of medicine and director of the AIDS Clinical Research Unit and co-director of the University of Miami Developmental Center for AIDS Research, commenting on the study.
Those at high-risk have multiple sex partners, use intravenous drugs or have multiple sexually transmitted diseases, Fischl said. "You are talking about a group that is at risk for multiple sexually transmitted diseases including HIV," she said.
However, it might be difficult to get the drugs to the people who need them, Fischl said.
"In addition, we need to identify people with HIV and get them into care, because in doing that we know that we decrease the transmission of HIV," Fischl said.
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This sounds promising and all, but there's one thing that they haven't mentioned with respect to the treatment, particularly with a drug like Truvada. The most common side effects include nausea, dizziness, dis-orientation or confusion, chronic diarrhea, lactose intolerance, and restless sleep. Of these, the three most common (in order of how common they are) are chronic diarrhea, dizziness, and nausea.
I don't mean to sound like a sour old bitty, but being on Truvada myself as part of my anti-retroviral treatment for HIV, I can tell you straight up that there are down sides to these medications that aren't often advertised in such publications. Personally, I find it a little misleading that the down side of such treatments is never mentioned, but the only thing that is mentioned is the links that they found suggesting that there's a plus side.
Don't get me wrong though, this does not mean that I'm apposed to the research in the field of preventing the spread of HIV, just that I find it a little insulting that the things that we as PHA's (Person with HIV/AIDS) go through as a result of the medications are never taught, even in the text books. In light of that, I can't help but wonder how much else is omitted from these articles, or if there's anything more behind the research that isn't made public. Although it seems on the surface that these treatments are proving to have some rather interesting results, one must really ask themselves, "Is this really the whole story?".
It also makes me wonder as to why they're limiting themselves primarily to the spread of HIV in heterosexuals. My reasoning for this is that these studies are being conducted in the United States, and it is a well known fact that within North America, the majority of PHA's as well as new HIV infections that occur are cases in gay men. Now that being said, in countries like South Africa, where their "days of the 80's" are right now, it is true that the majority of PHA's and new HIV infections are in cases of heterosexual females. This really makes me wonder, is this study being done in the United States really being done for the benefit of Americans, or is it just another way that the United States is spending millions, if not billions of dollars on funding projects for the benefit of countries half way around the world, before even thinking about addressing an epidemic within their own home land?
Again, don't get me wrong, I'm all for the research for the prevention of HIV, it's just that such things make you wonder whether taxpayer money is being spent primarily on the benefit of the taxpayers first, or if it's being spent on the benefit of other countries before their own? I can't help but get outraged by government bodies that invest more of their time and taxpayer money in handling issues of other countries, before taking a look at the epidemic in their own country.
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It also makes me wonder as to why they're limiting themselves primarily to the spread of HIV in heterosexuals. My reasoning for this is that these studies are being conducted in the United States, and it is a well known fact that within North America, the majority of PHA's as well as new HIV infections that occur are cases in gay men. Now that being said, in countries like South Africa, where their "days of the 80's" are right now, it is true that the majority of PHA's and new HIV infections are in cases of heterosexual females. This really makes me wonder, is this study being done in the United States really being done for the benefit of Americans, or is it just another way that the United States is spending millions, if not billions of dollars on funding projects for the benefit of countries half way around the world, before even thinking about addressing an epidemic within their own home land?
Again, don't get me wrong, I'm all for the research for the prevention of HIV, it's just that such things make you wonder whether taxpayer money is being spent primarily on the benefit of the taxpayers first, or if it's being spent on the benefit of other countries before their own? I can't help but get outraged by government bodies that invest more of their time and taxpayer money in handling issues of other countries, before taking a look at the epidemic in their own country.
Both trials were done in Africa. In one, a daily dose of Truvada, a combination pill that includes tenofovir disoproxil fumarate and emtricitabine, reduced the risk of getting HIV from infected partners by about 63 percent.
Earlier research found that PrEP reduced HIV transmission among gay and bisexual men, but whether it could prevent HIV infection among heterosexuals was unknown.
Rob
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Ok… That at least makes more sense then. It's the African government focusing on an epidemic in their country. In that case, bravo!
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Why can't they just use condoms… just saying it's simpler. How dumb need a person be, to take a drug with nasty effects instead of just using a condom... it's all for the pharmaceutical companies to get extra cash?
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Why can't they just use condoms
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This sends the wrong message if you know that a person has HIV and you still choose to have sex with that person then you MUST wear protection, its downright disgusting that drug companies are manipulating and abusing people like this knowing full well that these drugs will not stop infections in all cases - its irresponsible and inhumane - yes we should be looking at prevention rather then cure - but not by throwing due diligence and other proven preventative measures out of the window!
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Why can't they just use condoms… just saying it's simpler. How dumb need a person be, to take a drug with nasty effects instead of just using a condom... it's all for the pharmaceutical companies to get extra cash?
I believe it's most definitely for the cash. They put out new drugs knowing people will still get HIV which is a huge money maker for them. Coincidentally <sarcasm>, a lot of major pharmacy chains here in the USA are very supportive of the LGBT community or very gay friendly and I don't believe it's for the right reasons, just more money. I bet we'd be much closer to a cure, or have one, if it weren't for big pharmacy.</sarcasm>
