Canadian study finds usage greatly reduces risk
By Cazzy Lewchuk, Staff Writer
A PrEP (pre-exposure prophylaxis) drug with a brand name of Truvada has been found to greatly reduce the risk of HIV transmission in a new joint study between Quebec and France. The pill is currently only covered under federal health care as a treatment for HIV-positive patients. Although doctors are able to prescribe the drug for preventative purposes at their discretion, such usage is not covered under common medical insurance, and it is not a common practice to do so.
The study identified 400 subjects at high risk for catching HIV—in this case study, men who had unprotected anal sex with multiple partners. Half of the subjects administered Truvada and the other half a placebo before and after having sex—after 6 months, 14 men in the placebo group had contracted HIV, compared to 2 whom had taken Truvada. This showed an 86 per cent decline in HIV infection. Previous studies conducted have reached a similar conclusion.
Truvada’s role in combating the spread of HIV is still being studied, but part of its limitations involve the cost. Truvada’s market cost is close to $900 a month—particularly inaccessible to patients without private health insurance. This contributes to doctors’ reluctance or even unawareness of prescribing the medication, particularly with patients who are at risk but not yet HIV-positive.
Dr. Darrell Tan, a specialist in infectious diseases, provided a media statement about the drug: “The challenge is, there’s only a limited impact you can have when an evidence-based intervention cannot be accessed by the people who need it most.” Other factors limiting the success include frequency of dosage, as patients in the latest study took about 15 pills a month, and it is recommended that high-risk patients use the drug every day. Side effects of Truvada can include gastrointestinal rupture and kidney failure, so users must adhere to a schedule and regular testing to remain healthy.
Health Canada is currently reviewing an application to approve Truvada for specific HIV prevention. Applications can take up to a year to be approved. The potential for curbing HIV’s spread through Truvada is seen as an exciting possibility if its limitations can be overcome. Tan further explained: “This is a primary prevention intervention that belongs in primary care at the most basic levels of our health-care system, not at the level of highly specialized academic physicians.”
Truvada’s effectiveness and prevention is still being studied amongst those who benefit or would benefit from its usage, primarily amongst homosexual men. Further studies are needed to test effectiveness in reducing HIV for other at-risk behaviours, such as heterosexual sex or intravenous drug usage.
An estimated 75,500 people in Canada have HIV. Further estimates suggest that one in five of these people—just over 16,000—are unaware they have the virus.
