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CDC Urges Use of Anti-HIV Pill

Targeted groups include people with infected partners or those who don’t practice safe sex

People deemed to be at high risk for contracting human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS), should take anti-HIV medications that seem to cut the risk of transmission, the Centers for Disease Control and Prevention (CDC) has announced.

If used consistently, this approach — called pre-exposure prophylaxis (PrEP) — has been shown to reduce HIV infection rates by as much as 90%, the CDC noted.

“HIV infection is preventable, yet every year we see some 50,000 new HIV infections in the United States,” said CDC director Dr. Tom Frieden. “PrEP, used along with other prevention strategies, has the potential to help at-risk individuals protect themselves and to reduce new HIV infections in the United States.”

The new guidelines — published May 14 in Morbidity and Mortality Weekly Report — are tied to the 2012 approval by the FDA of the combination drug Truvada (emtricitabine/tenofovir disoproxil fumarate, Gilead) for use as PrEP, along with safe sex practices.

“While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the U.S. HIV epidemic today,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The new guidelines state that use of the PrEP regimen should be considered by the following groups:

  • Anyone involved in an ongoing relationship with a person who is already infected with HIV
  • Any gay or bisexual man who has had sex without a condom or who has been diagnosed with a sexually transmitted infection within the past 6 months and is not in a mutually monogamous relationship with someone who recently tested HIV-negative
  • A heterosexual person who does not always use condoms when having sex with people who might be at high risk for HIV (e.g., injection drug users or bisexual male partners whose HIV status is unknown) and is not involved with an HIV-negative person in a mutually monogamous relationship
  • Anyone who has abused injected, illicit drugs over the past 6 months, shared needles or other equipment associated with injected drug abuse, or been in a drug-abuse treatment program

The CDC is offering PrEP providers with support to help make sure that people on the regimen adhere to it as closely as possible — always an issue, the agency said. Pills need to be taken regularly, or the level of protection from PrEP drops dramatically, the CDC noted.

According to Dr. Dawn Smith, an epidemiologist in the agency’s Division of HIV/AIDS Prevention, the strategy will require teamwork.

“PrEP is a new approach to HIV prevention that requires continuing collaboration between patients and providers, as effectiveness requires adherence to daily medication and regular medical visits for monitoring, counseling, and testing,” she said.

Source: Dept. of Health and Human Services; May 14, 2014.

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