A 'Morning After' Rescue Pill? No!
Treatment GuideJust DiagnosedSex & DatingAfrican AmericanStigmaAsk the HIV DocPrEP En EspañolNewsVoicesPrint IssueVideoOut 100
CONTACTCAREER OPPORTUNITIESADVERTISE WITH USPRIVACY POLICYPRIVACY PREFERENCESTERMS OF USELEGAL NOTICE
© 2024 Pride Publishing Inc.
All Rights reserved
All Rights reserved
By continuing to use our site, you agree to our Private Policy and Terms of Use.
We urgently need new strategies to slow down the spread of HIV. With 5 million new cases a year worldwide and no vaccine in sight, pretreatment with an existing antiretroviral has seemed like a potential option. So far, a few studies have suggested that tenofovir (Viread) with or without emtricitabine (Emtriva) might be effective at knocking out HIV immediately after infection, but the data is far from conclusive. Unfortunately, society once again is moving ahead of science, since tenofovir is already being sold in dance clubs as a 'morning after' pill. According to a study by the Centers for Disease Control and Prevention in four metropolitan areas, 7% of gay men reported using tenofovir before 'risky behavior,' and 20% had heard of someone who had. But is this a good idea? The use of a treatment medication to prevent infection is not new. Malaria prophylaxis, for example, is standard for travel to areas with ongoing malaria activity. We know that using antiretrovirals on women during labor and delivery can reduce the possibility of HIV transmission to a newborn by at least 50%. And the risk of transmission after a needle stick is decreased 80% with immediate initiation of antiretrovirals, which are then continued for four weeks. As reported at last year's Conference on Retroviruses and Opportunistic Infections, the use of emtricitabine plus tenofovir prevented transmission of simian immunodeficiency virus in monkeys. In that study six rhesus macaques were given injections of emtricitabine and tenofovir for nine days and were then exposed to SIV rectally every week for 14 weeks. Six other macaques received no prophylaxis. At the end of the study five of the 'unprotected' monkeys were infected with SIV, but none of the treated monkeys picked up SIV. It is important to note that this is far better than a similar study in monkeys using tenofovir alone. As reported a year earlier at the 2005 retrovirus conference, four out of four monkeys on tenofovir became infected with SIV after weeks of exposure. The latest data was presented in August at the International AIDS Conference. In this study 731 at-risk women in Cameroon and Ghana were given rigorous safe-sex counseling, including information on condom use, and then divided into two groups--one receiving tenofovir and one receiving a placebo. The women were seen monthly for testing and repeat counseling. After one year two of 363 on tenofovir seroconverted and six of 368 on a placebo seroconverted. While this was a 68% reduction in seroconversion, it was not statistically significant. However, more data is coming. The CDC has three placebo-controlled trials under way. In Botswana the effectiveness of tenofovir plus emtricitabine is being studied in heterosexuals. In Thailand the effectiveness of tenofovir alone is being studied in injection-drug users. And in the United States a smaller study of 200 men who have sex with men in San Francisco and in Atlanta will look simply at the safety of using tenofovir versus a placebo and the behavioral effects of being on prophylaxis. (The National Institutes of Health has a study in Peru of 1,400 MSM to test tenofovir's effectiveness.) Data from these studies should be available in two to four years, but crucial questions need to be answered, especially since most experts do not expect medical prophylaxis to be 100% effective. For example, will there be a decline in concomitant safer-sex practices, like condom use, by patients when on prophylaxis? And if transmission does occur, will there be an increased amount of resistance to tenofovir or emtricitabine? Meanwhile, back at the dance clubs there are men buying a false sense of security with one pill of tenofovir when we have evidence that tenofovir was not fully effective even when taken daily. Nor is there an effective level of the drug present after two days--about the time HIV reaches the lymph nodes and starts to replicate. This is definitely not the time to be leaving the condoms behind.
From our Sponsors
Most Popular
The science behind U=U has been liberating people with HIV for years
June 04 2024 3:31 PM
As Pride party season begins, the CDC urges mpox vaccinations
May 16 2024 6:52 PM
Exclusive: We kiki with Q from 'RuPaul's Drag Race'
June 24 2024 11:37 AM
The freedom of disclosure: David Anzuelo's journey through HIV, art, and advocacy
August 02 2024 12:21 PM
How fitness coach Tyriek Taylor reclaims his power from HIV with self-commitment
September 19 2024 12:00 PM
Activist and philanthropist Bruce Bastian dies at 76
June 26 2024 1:28 PM
In honor of Juneteenth 2024, meet The Normal Anomaly
June 19 2024 1:39 PM
Creator and host Karl Schmid fights HIV stigma with knowledge
September 12 2024 12:03 PM
Plus: Featured Video
Latest Stories
Check out our 2024 year-end issue!
October 28 2024 2:08 PM
Meet our Health Hero of the Year, Armonté Butler
October 21 2024 12:53 PM
AIDS/LifeCycle is ending after more than 30 years
October 17 2024 12:40 PM
Twice-yearly injectable lenacapavir, an HIV-prevention drug, reduces risk by 96%
October 15 2024 5:03 PM
Out100 Honoree Tony Valenzuela thanks queer and trans communities for support in his HIV journey
September 18 2024 12:00 PM
Kentucky bans conversion therapy for youth as Gov. Andy Beshear signs 'monumental' order
September 18 2024 11:13 AM
Why activist Raif Derrazi thinks his HIV diagnosis is a gift
September 17 2024 12:00 PM
Study finds use of puberty blockers safe and reversible, countering anti-trans accusations
September 11 2024 1:11 PM
Latinx health tips / Consejos de salud para latinos (in English & en espanol)
September 10 2024 4:29 PM
The Trevor Project receives $5M grant to support LGBTQ+ youth mental health in rural Midwest (exclusive)
September 03 2024 9:30 AM
Introducing 'Health PLUS Wellness': The Latinx Issue!
August 30 2024 3:06 PM
La ciencia detrás de U=U ha estado liberando a las personas con VIH durante años
August 23 2024 2:48 PM
Tratamiento y prevención del VIH por inyección: Todo lo que necesita saber
August 23 2024 2:41 PM
Sr. Gay World quiere asegurarse de que estés bien
August 23 2024 2:30 PM
Eureka is taking a break from competing on 'Drag Race' following 'CVTW' elimination
August 20 2024 12:21 PM
With a new case in Sweden, what is the new mpox outbreak and should you be concerned?
August 15 2024 4:48 PM
From ‘The Real World’ to real life: How Danny Roberts thrives with HIV
July 31 2024 5:23 PM