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HEALTHWednesday 10 January 2018
Usage remains low for pill that can prevent HIV infection
By DAVID CRARY In this May 10, 2012 file photo, a doctor holds Truvada pills at her office in San Francisco. The pill bination with other drugs
AP National Writer has been shown to reduce the risk of getting HIV from sex by more than 90 percent if taken daily. as the basic treatment for
NEW YORK (AP) — From people who have HIV, the
gritty neighborhoods in Associated Press virus that causes AIDS. It is
New York and Los Angeles primarily spread through
to clinics in Kenya and Bra- language” — launched a lakis, a deputy commis- Under federal guidelines, sex.
zil, health workers are trying campaign to increase use sioner of the city’s health prime candidates for pre- Controversy arose in 2012
to popularize a pill that has among young Latino and department. ventive use of Truvada in- when the U.S. Food and
proven highly effective in black gay men and trans- However, Daskalakis said clude some gay and bisex- Drug Administration ap-
preventing HIV but which gender women. use among young black ual men with multiple sex- proved Truvada to reduce
— in their view — remains “We’ve got the tools to not and Hispanic men — who ual partners, and anyone the risk of getting HIV in
woefully underused.Mar- only end the fear of HIV, account for a majority of who does not have HIV the first place, for what’s
keted in the United States but to end it as an epidem- new HIV diagnoses — lags but has an ongoing sexual called pre-exposure pro-
as Truvada, and sometimes ic,” said the center’s chief behind. To address that, relationship with someone phylaxis, or PrEP. It blocks
available abroad in ge- of staff, Darrel Cummings. the city is making Truvada who has the virus. the virus from making cop-
neric versions, the pill has “Those at risk have to know readily available in some Abroad, a few govern- ies and taking hold. Critics
been shown to reduce the about the tools, though, clinics in or near heavily ment health agencies — warned that many gay
risk of getting HIV from sex and they need honest in- black and Hispanic neigh- including those in France, men wouldn’t heed Tru-
by more than 90 percent formation about them.” borhoods. Norway, Belgium, Kenya, vada’s once-a-day sched-
if taken daily. Yet world- In New York, roughly 30 “We like to go to the root South Africa, Brazil and ule and complained of its
wide, only about a dozen percent of gay and bisex- of the problem,” said Das- some Canadian prov- high cost — roughly $1,500
countries have aggressive, ual men are using Truvada kalakis, who personally inces— have launched a month.
government-backed pro- now, up dramatically from posed for the “Bare It All” major efforts to promote Gilead offers a payment
grams to promote the pill. a few years ago, accord- campaign. preventive use of Truvada assistance plan to people
In the U.S., there are prob- ing to Dr. Demetre Daska- According to the U.S. Cen- or generic alternatives, without insurance that cov-
lems related to Truvada’s ters for Disease Control and providing it for free or a ers the full cost. Some cities
high cost, lingering skepti- Prevention , Truvada would nominal charge. In Britain, and a few states — includ-
cism among some doc- be appropriate for about health officials in Scotland ing Illinois, Massachusetts
tors and low usage rates 1.2 million people in the U.S. and England recently took and Washington — also
among black gays and bi- — including sex workers steps to provide the medi- help cover costs. Activists
sexuals who have the high- and roughly 25 percent of cation directly through have pressed Gilead to
est rates of HIV infection. gay men. Gilead Scientific, government-funded pro- make its copay program
“Truvada works,” said Truvada’s California-based grams, though in England more generous in light of its
James Krellenstein, a New manufacturer, says there it’s in the form of a trial lim- profits from Truvada.
York-based activist. “We are only about 145,000 ac- ited to 10,000 people. “There’s no reason it has to
have to start thinking of tive prescriptions for HIV Truvada was launched in cost so much,” said Krellen-
it not as a luxury but as prevention use. 2004, initially used in com- stein.
an essential public health Gilead spokesman Ryan
component of this nation’s McKeel, in an email, said
response to HIV.” the company is reviewing
A few large U.S. cities are the copay program.
promoting Truvada, often “Like those in the advo-
with sexually charged ads. cacy community, we are
In New York, “Bare It All” committed to expanding
was among the slogans access to Truvada for PrEP
urging gay men to consult to as many people as pos-
their doctors. The Los An- sible,” he wrote.
geles LGBT Center — using In June, the FDA approved
what it called “raw, real a generic version of Tru-
vada, which is likely to
push the price down, but
it won’t be available in the
U.S. for a few years.
The Truvada debate has
taken many twists, as ex-
emplified by the varying
stances of the Los Angeles-
based AIDS Healthcare
Foundation — a leading
HIV/AIDS service
provider. q
