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Truvada for prevention if neg?

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General:
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   

Cliff:
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.

jordan:

I remember reading about that also.  They discuss it in the article posted on this webpage

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.

J.R.E.:
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

DingoBoi:
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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