CDC Expands PrEP Recommendation

The Centers for Disease Control today expanded its recommendation for the use of Truvada as a daily HIV preventive. The CDC now says that any person at risk for HIV, not just gay men, should consider taking the medication. Via the Bay Area Reporter:

Known as PrEP, for pre-exposure prophylaxis, the once-a-day pill regimen has been shown to be effective at reducing HIV infection rates. When taken daily as directed, PrEP can reduce the risk of HIV infection by more than 90 percent, according to studies. However, inconsistent use of the drug results in much lower levels of protection. “HIV infection is preventable, yet every year we see some 50,000 new HIV infections in the United States,” stated CDC Director Dr. Tom Frieden. “PrEP, used along with other prevention strategies, has the potential to help at-risk individuals protect themselves and reduce new HIV infections in the United States.” The new guidelines also stress that patients be tested for HIV prior to starting PreP and be tested again at three-month intervals so if someone on PrEP does become infected with HIV they discontinue taking the drugs and begin HIV treatment.

The Los Angeles-based AIDS Healthcare Foundation fiercely opposes the use of Truvada as an HIV preventive, calling it a "party drug" that encourages unprotected sex. Almost all other HIV/AIDS organizations disagree with the AHF.

Read the CDC's full report.

UPDATE: The AHF has issued a press release in response.

“This is a position I fear the CDC will come to regret. By recommending widespread use of PrEP for HIV prevention despite research studies amply chronicling the inability to take it as directed, and showing a limited preventive effect at best, the CDC has abandoned a science-driven, public health approach to disease prevention—a move that will likely have catastrophic consequences in the fight against AIDS in this country,” said Michael Weinstein, AHF’s President. “What about other STDs like syphilis, which has seen a resurgence approaching epidemic proportions in some of the same communities that the CDC wants to target for PrEP? Despite CDC and FDA requirements for risk-reduction counseling and condom use while taking PrEP, the government-sanctioned widespread deployment of PrEP will be accompanied with a shift to condom-less sex. The CDC would be better advised to put its weight behind HIV testing and linkage to treatment for the estimated 20% of the 1.3 million people living with HIV in this country today who have never been tested for the disease. Finding those individuals and linking them into care and treatment would do far more to break the chain of new HIV infections and improve the public health than the CDC’s ill-advised recommendation to widely prescribe PrEP—a costly and powerful medication—to uninfected individuals.”