US Expert Panel Supports HIV-Prevention Pill for People at High Risk

In 2012 the Food and Drug Administration approved the use of Truvada to prevent HIV infection in people at high risk

In 2012 the Food and Drug Administration approved the use of Truvada to prevent HIV infection in people at high risk

In San Francisco, Havlir, along with Dr. Susan Buchbinder, director of Bridge HIV at the San Francisco Department of Public Health, has pioneered a program called "Getting to Zero San Francisco", aimed at making the city the first in the U.S.to have zero new infections over a year.

But obstacles remain. The only U.S. Food and Drug Administration-approved drug for PrEP, Truvada, now costs $20,000 a year, said Dr. Rochelle Walensky, an infectious disease specialist at Massachusetts General Hospital in Boston.

The Centers for Disease Control and Prevention (CDC) recommend everyone between the ages of 13 and 64 be tested for HIV at least once.

"We have seen firsthand at our clinics how the scale up of PrEP can dramatically decrease the rates of new HIV infection, and improve the quality of life for those individuals who have access to this intervention", said Dr. Antonio Urbina.

Gay men are considered at "high risk" of developing HIV, and the task force also includes those who have sex without a condom, people who have sex with partners who don't know their HIV status, and IV drug users.

Currently, he says, there are up to 1.2 million people in the US who are potentially at higher risk of getting an HIV infection than the general population, but fewer than 30% of them are taking advantage of PrEP.

The USPSTF did not find enough evidence to set screening intervals, but it concluded that "repeat screening is reasonable for persons known to be at increased risk of HIV infection", including sexually active men who have sex with men, people who inject drugs, and/or those who are involved with commercial sex work.

In an accompanying editorial, Dr Hyman Scott and Dr Paul Volberding, professors of medicine at the University of California, San Francisco wrote that the new recommendations depict "a maturation of evidence and policy in HIV medicine" and a consensus about how to end transmission. Not all insurers cover the entire cost of PrEP either, leaving patients with high co-pays, but with the USPSTF's new guidance, more payers should be convinced that the drug is worth reimbursing.

"The gap between indication and use is most pronounced among black and Latino men who have sex with men", Volberding and Scott write.

Each year, about 40,000 people in the USA are diagnosed with HIV. The pill contains two medications, which help prevent HIV from establishing permanent infection, according to the CDC.

U.S. health officials are urging doctors to prescribe a daily prevention pill to anyone at high risk of HIV infection in new National guidelines released Thursday.

PrEP users take a pill every day.

The studies found that most side effects, including gastrointestinal complaints and some nausea, were mild and reversible.

So while the USPSTF has taken an important step toward the goal of ending the HIV epidemic in the US, execution in the most at-risk communities will be crucial, they suggested.

The task force assigns a letter grade to each of its recommendations based on medical evidence and the treatment's potential benefits.

The U.S. Centers for Disease Control and Prevention has more about pre-exposure prophylaxis. He says he hopes more providers will talk to their at-risk patients about taking the daily medication, which is also known as PrEP.

"Besides near-perfect protection against HIV, PrEP is a good gateway for young adults to access preventive and primary care services", Urbina added. The task force assigned an A to the HIV prevention treatment.

EPLING: We've done a good job in medicine at being able to treat HIV in the sense that it's now become essentially a chronic disease for most people. About 40% of new infections are transmitted by people who didn't know they had the virus, according to the CDC.