OUTLOOKjune2014.pg30-31.qxp_OUTLOOK OHIO TEMPLATE 5/23/14 2:49 AM Page 1
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Is This Pill the Answer? ARC Ohio Embraces New Strategy for HIV Prevention by Bob Vitale In every city with a Pride parade, young activists in T-shirts and young dancers in washboard abs will be tossing out condoms by the fistful. But here’s what Bill Hardy, president and CEO of AIDS Resource Center Ohio, calls “kind of the dirty little secret we’ve been wrestling with,” both in Ohio and elsewhere around the country: A lot of them will go unused, just as nearly 30 years of safe-sex messaging is going increasingly unheeded. Treatment advances have brought about a 20-year decline in annual deaths from AIDS, but Ohio’s HIV infection rates particularly among men who have sex with men - are rising to levels not seen since the mid-1990s. Could one of the top-selling drugs for
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people with HIV also be the answer to keeping people from getting infected in the first place? In May, the federal Centers for Disease Control and Prevention advised doctors to consider prescribing the HIV drug Truvada to HIV-negative people considered at substantial risk of infection. Truvada stops HIV from reproducing in the bodies of people with the virus, lowering the level of HIV in their blood. As a pre-exposure prophylaxis - or PrEP - it blocks the virus from ever attaching to blood cells when people who are HIVnegative are exposed. Dr. Jonathan Mermin, who heads the CDC’s HIV/AIDS prevention efforts, called PrEP “a powerful tool that has the potential to alter the course of the US HIV epidemic.”
ARC Ohio was on board even before federal officials issued their guidelines, which recommend Truvada for gay and bisexual men who’ve had bareback sex in the last six months, for anyone in a relationship with an HIV-positive partner, for straight men and women who don’t use condoms with partners known to be at risk for HIV, and for people who’ve injected drugs or shared equipment. In April, the board of the statewide organization voted to implement a PrEP strategy at its clinics in Dayton and Columbus. ARC Ohio is one of 68 HIV/AIDS service organizations around the country to endorse the drug’s use. Hardy said the plan is in the works and should be in place by the end of summer. Clinical trials found that Truvada reduced the risk of HIV infection by up to
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99 percent in gay and bi men who took it consistently. Among men and women with HIV-positive partners, the drug reduced the risk of infection by 75 percent. The US Food and Drug Administration approved Truvada for people without HIV in 2012, but its use as a prevention tool by doctors and advocates has yet to be widely embraced. Hardy calls that “peculiar,” although he said much of the trepidation has had to do with the feeling that positive reports on PrEP might be too good to be true. Gilead Sciences, the maker of Truvada, hasn’t pushed its drug as a preventive tool, some suggest because of longsimmering debate among HIV/AIDS professionals and among gay men over whether PrEP would cause an even further erosion of the safe-sex message. outlookohio.com