POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: General on July 24, 2006, 06:25:36 pm
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Hello-
I was diagnosed in March and have been using Truvada and Sustiva ever since. During a recent discussion with a friend who claims to be negative, he insists that Truvada can be used for prevention. When I questioned exactly what he meant he likened it to a morning after pill.
Again, I'm new to the world of HIV and meds, but this just didn't make sense to me. I was under the impression that Truvada was typically used as part of a combo, so I can't imagine how taking it alone could be beneficial. I also can't comprehend how simply taking the pill once after a risky encounter could prevent someone from contracting the virus.
Does anyone have any info on this theory?
Thanks
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Last year I read about ongoing studies trying to determine if taking Viread, by those in high risk group, can act as a vaccine and reduce HIV infections. But they are still testing it, so no one knows for sure. I don't think it's a matter of just taking it once. I think that study is more like people taking it constantly. I don't think taking it once is very beneficial. You probably wouldn't build up enough of the drug in your tcells that quickly. Your friend is putting himself at risk for not only becoming infected, but possibly becoming infected and resistant to Viread.
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I remember reading about that also. They discuss it in the article posted on this webpage (http://twotermslater.blogspot.com/2006_03_01_twotermslater_archive.html)
Here's the article:
The pharmaceutical company Gilead Sciences Inc. has stumbled across something that could change the way we think about AIDS. Their new combination drug Truvada is a mix of existing anti-retrovirals Viread and Emtriva and seems to prevent the transmission of HIV in animals. Six macaques were exposed to monkey and human HIV while taking Truvada; none became infected.
For good reason, Gilead is not touting this novel approach to stopping the AIDS epidemic. There's concern about testing Truvada's abilities to prevent transmission of HIV in humans, though studies with Viread were carried out in Cambodia in sex workers. Exposing cohorts of patients to a known terminal virus without cure is ethically impossible. For this reason, the use of Truvada to prevent HIV transmission has been strictly off-label.
Still, despite the testing difficulties, the concern is that the new drug does not completely prevent HIV transmission. Furthermore, complete prevention would require regular dosing before and after sexual activity. Considering the inherent issues with other forms of protection, such as condoms, one can imagine the problems associated with a pill taken daily. The efficacy of all forms of safe sex is directly related to their correct use. A number of women on birth control become pregnant every year because of missed doses or unrealized drug interactions.
Problematic to me is the recent trend of "healthy men taking Viread and Viagra before a night on the town." I fear that these men are thus not using condoms and further contributing to the spread of other STDs. This is not a healthy trend that should be embraced; I'm happy that Gilead has not pursued approval of this new use.
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Hello General,
And here is some more info that I had posted from the old forums :
http://www.aidsmeds.com/Fusetalk/messageview.cfm?catid=5&threadid=26636&FTVAR_MSGDBTABLE=
I had posted a link to something to this effect a while back. This is from the Advocate.com :
December 20, 2005
Some gays use anti-HIV drug as a preventative
The anti-HIV drug Viread, also known by its generic name tenofovir, is quickly becoming a popular club drug among gay and bisexual men, who take the medication in the hope that it will prevent them from being infected with HIV during unprotected sex, the Los Angeles Times reports. Use of the drug has become so popular that Viread is often sold in packets along with ecstasy and crystal meth at gay clubs and is even referred to as “taking a T” by HIV-negative gay men who use it.
Research is currently under way around the world to gauge whether Viread use can prevent HIV infections. Two continuing U.S. studies, in Atlanta and San Francisco, include sexually active gay men who are taking daily doses of the medication. Studies in Africa and Asia are focusing on Viread’s protective effects among sex workers and injection-drug users.
But AIDS experts warn that there is no evidence yet from the studies to confirm that Viread use prevents HIV infections, and they worry that gay men who use the drug instead of condoms could be placing themselves at high risk for HIV infection. A Centers for Disease Control and Prevention study found that 7% of HIV-negative men had used Viread before engaging in risky sex, believing that the medication would protect them against infection.
“This is a very worrisome development," David Hardy, an HIV doctor at Cedars-Sinai Medical Center in Los Angeles, told the Times.
AIDS experts also say that even if studies show Viread offers some protection against HIV infection, they would recommend its use in conjunction with condoms, not as a replacement for them. “We would never recommend people stop using condoms,” Jeff Klausner, director of sexually transmitted disease prevention for the San Francisco health department, told the Times.
But some doctors already are prescribing Viread for their sexually active gay patients, particularly those who do not use condoms. For Mark Conant, an HIV doctor in San Francisco, the drug is the only means of protection some of his patients will use. "What choice do I have? Everyone knows condoms work, but they're not using them,” he told the Times. "All I am trying to do is reduce the risk that people harm themselves." So far, he says, two of his patients he describes as “very sexually active” who regularly use the drug have remained free of HIV infection.
Health officials in San Francisco plan to survey gay men next year to determine how many of them are using Viread either in conjunction with or as a replacement for condoms. If the rates are high, the city may launch an educational campaign to inform gay men of the risks of relying on an unproved HIV prevention method. (Advocate.com)
Take Care----Ray
http://www.advocate.com/news_detail_ektid23557.asp
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anyone who takes it as a substitute for proper condom use is a fool and a tool. They'll be joining us here shortly :-\
Now, if someone takes it who is highly active and/or with known hiv postive people, in the event of a condom break, it may 'help', but it's far from proven.
Given the cost of it... ugh? how are they paying for this out of pocket? Insurance sure won't cover it.
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When I questioned exactly what he meant he likened it to a morning after pill.
Hi General... and welcome to the forum BTW.
I think what your friend was talking about was something called PEP - Post-Exposure Prophylactic. It is taken after an exposure to hiv and it isn't a "morning after" pill, it is four week regimen of toxic drugs that might stop hiv from replicating and infecting the body.
It's only in fairly recent times that it has been available for use after a sexual exposure. It's mainly been used in a medical setting when a health care worker has had a needle-stick injury while caring for an hiv positive person, or a person whose hiv status is not available.
The experimental preventative method Cliff and the guys are talking about is something taken BEFORE a possible exposure, while PEP is something taken AFTER a possible exposure - hence the belief some have that it is a "morning after pill", when in fact it is not just the morning after, but twenty eight mornings after.
Hope that clears things up for you a bit.
Ann
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Thanks to all who offered answers...very helpful. :)
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Hello ,
And I believe the following link may be a little more current Reguarding Truvada testing. From TPAN :
Scroll to the bottle...
http://www.tpan.com/publications/pa/jul_aug_06/news_briefs.shtml#story11
"From Viread to Truvada
The U.S. Centers for Disease Control and Prevention (CDC) has expanded its research into the prevention of HIV using HIV medication. The study uses the HIV drug Viread to see if it prevents infection due to sexual exposure. It will now also test the HIV drug Truvada, which is a two-in-one pill combo of Viread and Emtriva. Recently reported results with monkeys found Truvada to be even more effective than Viread alone. Viread is being tested in Atlanta and San Francisco for prevention in men who have sex with men (MSM), and the CDC will add a third U.S. city (not yet identified) to study the use of Truvada for prevention among MSM.—EV"
Ray
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Hello ,
And I believe the following link may be a little more current Reguarding Truvada testing. From TPAN :
Scroll to the bottle...
http://www.tpan.com/publications/pa/jul_aug_06/news_briefs.shtml#story11
"From Viread to Truvada
The U.S. Centers for Disease Control and Prevention (CDC) has expanded its research into the prevention of HIV using HIV medication. The study uses the HIV drug Viread to see if it prevents infection due to sexual exposure. It will now also test the HIV drug Truvada, which is a two-in-one pill combo of Viread and Emtriva. Recently reported results with monkeys found Truvada to be even more effective than Viread alone. Viread is being tested in Atlanta and San Francisco for prevention in men who have sex with men (MSM), and the CDC will add a third U.S. city (not yet identified) to study the use of Truvada for prevention among MSM.—EV"
Ray
I came here tonight doing some research on the general consensus regarding re-infection and/or superinfection and came across this particular thread. So, let's assume, for the sake of argument, that Truvada does have some effectivness in preventing HIV infection. Two questions:
1. What if one were to be exposed to a strain that was resistent to the drugs in Truvada?
2. If one is on Truvada anyway (as I am), would that imply that you might be even less at risk of re-infection??
Discuss.
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JP, I started another thread (http://forums.poz.com/index.php?topic=2340.0) to discuss your questions.
- matt