An increased push for using PrEP may also create a black market for the drug among marginalized communities, according to a data analysis of South African men. In a presentation to the Conference of the Association for the Social Sciences and Humanities in HIV held in South Africa recently, researcher Steven Kurtz explained that any push for men who have sex with men to use PrEP must also address the possibility for illicit use for preventative purposes and the black market trading of the drug, according to AIDS Map.
"The potential intersection of widespread ARV street markets and misinformed at-risk populations about the effective use of PrEP is a major public health concern," said Kurtz.
Kurtz used analysis of current antiretroviral medications and how they are sometimes sold on black markets for illicit use in South Africa. He determined that the number one factor that led to men selling their medications was economic vulnerability. Other high risk indicators were homelessness and being a man.
In most cases (74 percent) men traded their drugs for cash in order to buy drugs or alcohol, while others (23 percent) sold their drugs to pay for living expenses. The remainder passed their drugs on in order to help someone out.
Kurtz found that the most commonly traded drug was Truvada, the drug the FDA has approved for PrEP but is also used as an antiretroviral in a different combination to treat HIV. He suspected that the most common use for Truvada was not getting high but preventing HIV infection.
Needless to say, men who traded their medications on the black market had poor adherence to treatment. However, in his analysis Kurtz concluded that patients taking Truvada should be informed about the purpose of PrEP and how to take it effectively while also widening access to the drug. While his research gave more insight into who is selling rather than buying ARVs, Kurtz research brings up important points about unsafe use of PrEP and some of the myths surrounding its use.