An interesting paper on HIV-1 prevention came out while I was on my Grand Adventure:
Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men
Quick summary: They used an antiretroviral, Truvada, as a prophylactic drug. That is, you take this antiretroviral every day in the hopes of preventing infection as opposed to taking the drug to control infection.
Basically, its The Pill… for HIV-1 infection instead of pregnancy.
And it actually kinda worked!
People who took the drug as instructed, had a 92% lower chance of becoming infected than placebo.
… Yeah, no, read that again: “People who took the drug as instructed”.
Lots of people didnt take the drug properly, which is just asking for trouble, evolutionarily, and was a problem practically in that the overall lowered risk in the treatment group was only 44%, not 92%.
And then we have cost issues: One pill? $36. Yeah.
Gotta take it every day.
And then theres the fact we already have an anti-HIV-1 prophylactic out there that works really well when used as instructed. Condoms reduce your chances of becoming HIV-1 infected at about 80-90%, and dont cost very much (freely available lots of places), nor do you have to remember to wear a condom every day. Just when you are having sex. And they dont have side-effects (unless youre allergic to latex). And then theres the fact that HIV-1 is not going to evolve resistance to condoms.
It would be better if this kind of prophylactic were available for women in high-HIV areas who are not in control of their sexual partners (aka, the wives of married men who are sleeping around and coming home and infecting their wife and subsequent children because they wont wear a condom), but at $36 a pop, thats not going to happen today. Or tomorrow.
At this point it just looks like an overly convoluted ‘answer’ to a problem we already have an answer to. And in a lot of situations, the old answer is the much better answer.
On 2 October, two dozen AIDS researchers gathered at the Eden Roc hotel on Millionaire’s Row in Miami Beach, Florida, to learn whether an HIV prevention study they had just completed would become a millstone or a milestone for the field.
… Unlike the many HIV prevention trials that have failed or had positive but barely significant results, the study–called the Pre-Exposure Prophylaxis Initiative (iPrEx)–showed unequivocally that the treated group had 44% fewer infections after an average of 1.2 years. More encouraging still, most of the failure seemed to occur among those who did not take the pill as directed: A small substudy found that risk of infection plummeted by 92% in people who had measurable drug levels in their blood. The researchers applauded and some even cried when they heard the bottom line.
O.o… alright… okay… alright…