Ever since Truvada was approved for use as PrEP in 2012, detractors of the HIV prevention pill have strongly cautioned against the drug because of the alleged side-effects associated with its use. Although the more sensational claims of drug resistance and rampant kidney failure have largely been dispelled, discussions about PrEP still receive static when the safety of PrEP use is discussed.
Researchers from the David Geffen School of Medicine at the University of California Los Angeles performed a narrative review comparing five major studies on PrEP for HIV infection with two major studies on aspirin Safety. Each medication was given a score based on how numbers needed to harm (NNH), or cause a reported side effect.
For PrEP, the NNH for gay and bisexual men and transgender women was 114 for nausea and 96 for unintentional weightloss. In heterosexual couples, the NNH was 68 for moderate decreased absolute neutrophil count. Aspirin received an NNH score of 909 for major gastrointestinal bleeding and 123 for any gastrointestinal bleeding. Bleeding problems received a 15 for men and easy bruising received a 10 for women.
The report concluded that the use of Truvada as PrEP was favorable to Aspirin in terms of safety, but that more studies on long-term use were needed. Still, those users who have engaged in short or medium term PrEP should be reassured of the drug’s safety.