Pill That’s Supposed to Protect against HIV Infection Failed?
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The first case of HIV contracted by a person taking the PrEP drug regimen has been reported. PrEP is designed to prevent HIV infection, but one man in Canada reportedly contracted a rare, multi-drug-resistant strain of HIV in spite of taking PrEP.
“Does this ‘failure’ change anything at all?” asks ER Physician Dr. Travis Stork. Gastroenterologist Dr. Jorge Rodriguez was at the International AIDS Conference in Boston when the news broke, and explains, “PrEP is a technique, it isn’t a pill. It stands for ‘pre-exposure prophylaxis.’ You’re taking something before you’re exposed to it. For people at high risk for HIV, if they take one pill a day they’re 97 percent less likely to catch HIV if they engage in the most unsafe sexual habit.”
Because many people are now on PrEP, the incidence of new infections and the number of people becoming HIV positive has dropped tremendously.
“All of these studies are showing it’s 97 percent effective -- not 100 percent,” notes Dr. Rodriguez. “So this wasn’t a surprise.”
Dr. Stork observes that one of the concerns when PrEP was introduced was that patients would no longer practice safe sex. And this does seem to be happening – rates for most STDs have gone up.
Urologist Dr. Jennifer Berman is concerned about the drug-resistant HIV strain. She asks, “Did that guy trace back who he had slept with who may have carried the resistant strain?” Dr. Rodriguez says they don’t know who he contracted the virus from.
Finally, Dr. Rodriguez cautions that HIV isn’t the only virus people need to worry about. “I’m pro-PrEP, don’t get me wrong …” “… because it’s an additional layer of protection,” finishes Dr. Stork. “For one particular virus, not for all the STDs out there.” People on PrEP still need to take precautions.
Dr. Berman wonders about monogamous couples where one partner is infected with HIV and the other isn’t. “That would be a great situation for PrEP,” agrees Dr. Rodriguez.
The final word is that PrEP is highly effective, but it’s not a magic bullet. The safest thing to do is to combine it with standard safe-sex practices – and lower your odds of contracting all STDs, including HIV.