February 2012, New York, N.Y.: People on their way to the Black Party report seeing pushers on the street selling a brand new "party kit" which allegedly included ecstasy, Viagra, and a pill to prevent HIV infection.
July 16, 2012, Silver Spring, Md.: The U.S. Food and Drug Administration approved the drug Truvada from Gilead Science to reduce the risk of HIV infection in uninfected individuals who are at high risk of HIV infection.
November 30, 2012: ManhuntCares sends out an email broadcast to Manhunt users to commemorate World AIDS Day with the tag line "HIV Prevention Pill for Negative Men: A choice when condoms are in the way or not enough?" (The tagline was later changed to: "HIV Prevention Pill for Negative Men: Another choice for staying HIV free?" to avoid mischaracterization of the message).
Today: Pre-Exposure Prophylaxis (PrEP) for HIV, the strategy that uses medications before exposure to HIV in order to prevent possible infection, is an exciting topic for both professionals working in HIV prevention and the general public.
PrEP is also generating quite the debate in academic and informal fora and -- alas -- a series of potentially harmful misconceptions. As the Center of Disease Control (CDC) prepares comprehensive guidelines for the use of PrEP, health educators believe it's important to address incorrect information and wishful thinking, especially around three core points.
First and foremost, PrEP does not represent an alternative to condoms. Truvada is not intended to be used in isolation. The medication has been studied in combination with traditional HIV prevention methods. This means that our dear condoms are not ready for retirement just yet. Additionally, latex is still the best trick to avoid the constellation of sexually transmitted infections other than HIV.
Second point, Truvada does not work like -- say -- Viagra or Cialis. It is not meant to be taken before sexual encounters or in preparation to a very fun weekend. PrEP is a daily oral dose of antiretroviral drug. It requires strict adherence to the medication every single day and frequent HIV testing. In other words, it is a commitment.
Lastly, PrEP is not for everyone. It is recommended for folks at high and ongoing risk for HIV infection, for example people who are HIV negative and have regular sexual encounters with HIV infected partners and, even in these cases, PrEP should not be seen as the first line of defense against the virus.
The use of HIV medications to prevent new infections is not a new concept per se. PrEP is part of treatment strategies that proved to be extraordinarily effective in preventing new infections including: taking HIV drugs shortly after exposure (post-exposure prophylaxis or PEP), accessing treatment to avoid mother-to-child transmission, and treat HIV positive folks in order to achieve viral suppression (less virus in the blood is linked to fewer infections).
The critical point is to welcome PrEP with open arms in addition to what already works. PrEP is a fantastic opportunity -- as resource in the ever-growing tool box of HIV prevention. And as we welcome new advancements, let's keep an eye on the history of the epidemic.
We learned that not only viruses harm. Ignorance causes damage, too.
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