Federal health authorities are advocating that people at risk for HIV infection take a daily dose of Truvada to prevent AIDS, The New York Times reported
The move is a reversal of policy by the Centers for Disease Control and Prevention, which had urged at-risk men to rely on condoms.
Health authorities have been unable to persuade men vulnerable to the virus to always use condoms. The rate of prophylactic use has steadily declined among gay men, while the number of HIV infections has persisted at 50,000 annually.
Public health educators have spent the past three decades urging the use of condoms to block HIV transmission. Still, the number of gay men who said they engaged in unprotected sex has risen by almost 20 percent, the Times reported.
While officially the new CDC policy calls for the use of both condoms and the pill, health experts are aware that many gay men will feel encouraged to shift completely away from condom use. This is expected to lead to an increase in venereal disease rates.
Public health experts have nevertheless concluded that the pill is the best way to stop the spread of AIDS.
"Making the perfect the enemy of the good is something we've got to get over," Dr. Anthony Fauci, one of the foremost AIDS experts in the country, told the Times. "I strongly support the CDC doing this."
Some 500,000 men are expected to seek prescriptions for Truvada which costs about $13,000 a year. The drug is covered by most insurers and by state Medicaid.
High-risk groups include homosexual men who engage in unprotected sex, heterosexuals with high-risk partners, and drug addicts who share needles.
For now, Truvada is the only pill approved by the Food and Drug Administration for AIDS prevention. The drug combines tenofovir and emtricitabine and is considered comparatively safe, the Times reported.
The protocol requires pre- and follow-up testing for those taking the medication.
Not everyone in the healthcare community supports the change in CDC policy. Michael Weinstein, president of the AIDS Healthcare Foundation, described Truvada as a "party drug" according to the Times.
He added that use of the pill would encourage
condom-less sex and more STDs. He noted that many people who have HIV have never been tested for the disease.
"Finding those individuals and linking them into care and treatment would do far more to break the chain of new HIV infections" than switching policy away from condoms to a daily pill, he said, according to the Times.
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