“We should not be stigmatizing people who decide that PrEP is an appropriate strategy for them any more than we should be stigmatizing women who choose to take the birth control pill or those who access clean needle exchange programs. “
enough about toxicity when it is taken for long periods of time. Or about what happens if people take it intermittently—which could be dangerous in terms of leading to the development of drug-resistant strains of HIV (another reason that it’s safest for people taking Truvada to also use condoms).
proper compliance. At the Center, we currently have no funding to offer PrEP beyond participants in our research study or patients with private or government insurance. So, as things currently stand, not everyone who needs or wants PrEP can access it. As soon as this changes, we’ll be sure to let you know.
At the Center, our Research Department is hard at work trying to find some answers. There are five studies underway in Los Angeles right now, and ours is one of the largest. We are focusing on people who are at high risk of HIV infection. We anticipate that it will be 18–24 months before enough research has been done to yield information about proper dosage. Right now we’re operating by the Centers for Disease Control guidance that PrEP should be taken daily and that people on PrEP must come back to get tested at least every 90 days.
Who do I think should take PrEP? As someone who has spent more than 30 years actively engaged in the fight against HIV and AIDS, my answer is: anyone who wants it after consulting with his/ her physician and who can comply with the medication regimen. We should not be stigmatizing people who decide that PrEP is an appropriate strategy for them any more than we should be stigmatizing women who choose to take the birth control pill or those who access clean needle exchange programs. Ultimately, this is about individual choice and using every means at our disposal to end the epidemic. PrEP is a powerful tool in that pursuit and, as such, should not be dismissed but should be used wisely. We’re working as quickly as we can at the Center to help understand exactly what wise usage is. Stay tuned.
Of course, at about $13,000 a year, PrEP isn’t cheap. (Although, as the WHO report indicates, PrEP is far cheaper than the costs of a lifetime of treatment for someone with HIV.) Many insurance carriers cover PrEP, but not all do so affordably or in ways that encourage
Fall 2014
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