PrEP or Pre-Exposure Prophylaxis (rhe word “prophylaxis” means to prevent or control the spread of an infection or disease.) is the hot topic in the HIV medical world.
The goal of PrEP is to prevent HIV infection from taking hold if you are exposed to the virus. This is done by taking one pill every day. These are some of the same medicines used to keep the virus under control in people who are already living with HIV.
Our INTERVIEW WITH A TRUVADA WHORE focuses on what a person who currently is on the PrEP trial thinks of it, but what about from a Doctors point of view.
We decided to get in contact with Mike Youle- a British doctor and clinical researcher specializing in HIV treatment. He publicised the concept of pre-exposure prophylaxis (PREP) for HIV and has studied the health economics of HIV therapy. He is also the director of the charity Justri.
1. What do you think of PrEP and what is it’s future in HIV prevention?
PREP clearly works and we now have data showing that you don’t need to take it continuously. Most of the studies to date have used TRUVADA but there are several other antiretroviral drugs that should work that are less likely to have side-effects or long-term toxicity. Also long acting preparations are also in development. So, it represents a good way of preventing HIV infection even though it is expensive compared to condoms and will be more difficult to justify providing for free to all but the highest at risk of infection.
2. How important is adherence?
Probably quite important as in the original studies taking the TRUVADA regularly was associated with the lowest risk of infection but it may be that you really need to take the drug just before and continue for a few days after sex. These timescales are being looked at in other studies at the moment.
3. What is your view on users who want to replace condoms with PrEP?
PreP only protects you against HIV, and also probably herpes and hepatitis B, so you can still get warts, syphilis, LGV, chlamydia and hepatitis C and other infections. Personally, I would see PrEP as an additional protection to condoms but how unrealistic this view is will emerge over time. Caveat emptor – buyer beware.