The Future of HIV Prevention: Truvada PrEP

Written by Mary Ellen Ellis | Published on August 21, 2013
Medically Reviewed by George Krucik, MD, MBA on August 21, 2013

HIV Infection and AIDS

The human immunodeficiency virus (HIV) causes an infection that currently has no cure. The virus affects the immune system and over time, can destroy it to such an extent that acquired immunodeficiency syndrome (AIDS) develops. At this stage, an infected person can no longer fight off other infections and diseases.

Research over the last couple of decades has led to new medicines and treatments that allow people to live with HIV for much longer than ever before, and without developing AIDS.

Transmission and Incidence of HIV

HIV is transmitted from one person to another through bodily fluids. According to the Centers for Disease Control and Prevention (CDC), the virus is mostly spread through unprotected sex and the sharing of drug needles in the United States.

The most recent data from the CDC show that the incidence of new HIV infections in the United States in 2010 was around 50,000. Although the number is stable, government agencies such as the CDC hope to bring the number down with new treatments and preventions.

PrEP for Prevention

Medications for treating HIV have improved. However, prevention is still an important factor in reducing the incidence of the disease. To that end, people who at high risk for developing the virus are encouraged to use pre-exposure prophylaxis (PrEP).

PrEP involves taking daily medication that helps to prevent the transmission of an HIV infection. It also includes other risk-reducing techniques, such as treatment for drug addicts or education about safe sex practices.

FDA Approval of Truvada

The Food and Drug Administration (FDA) approved Truvada, the drug being used for PrEP, in 2012. The FDA had already approved Truvada as a treatment used in combination with other drugs to treat patients with HIV.

Truvada must be taken daily as a prophylactic medicine. FDA approved the drug as a preventive measure with the provision that patients must also participate in education and counseling to help reduce their risk of infection.

The Proof Is in the Research

The FDA approved the use of Truvada as part of a comprehensive PrEP program because research shows that it can reduce infection rates. One such study from the CDC saw a significant drop in the risk of infection among participants.

The study included 1,200 sexually active men and women. Researchers found that there were 63 percent more infections in the placebo group compared to the group that received Truvada daily.

Truvada for Drug Users

Another study from the CDC showed that Truvada PrEP was also effective in preventing infection among intravenous drug users. Over 2,000 drug users participated in this study. The risk of infection in those taking Truvada instead of placebo was reduced by 49 percent.

Some of the participants reduced their risk by an even greater amount. These were the drug users that strictly adhered to the daily pill regimen.

Are You a Candidate for Truvada PrEP?

Truvada PrEP is intended for use by anyone who’s at a high risk of developing an HIV infection. This includes people who engage in unprotected sex with multiple partners and intravenous drug users who share needles.

Any uninfected person in a relationship with someone who has HIV is also at risk and eligible to use Truvada prophylactically.

Who Can’t Use Truvada PrEP?

The FDA states that Truvada PrEP should only be used by people known to be HIV-negative. Anyone using the prevention program has to be tested for the virus first and again every three months.

Truvada should not be used by anyone with bone or kidney problems or hepatitis B. The medication may worsen these conditions.

Dropping the HIV Infection Rate

The incidence of HIV infection has hovered steadily around 50,000 for several years. Government agencies like the CDC and FDA hope that the introduction of Truvada PrEP will help to bring this number down.

While a steady number is better than a rise in infections, a drop in HIV incidence would be the best possible outcome.

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