PrEP, technically called pre-exposure prophylaxis, is the term for proactive and preventative drug measures for those who are at high risk for HIV contraction. Men who are at a high risk of the virus can take HIV medication, called Truvada, to lower the likelihood of contracting the illness. PrEP, when taken consistently and as prescribed, is very effective at curtailing HIV from spreading throughout the body.
Recent HIV Cases Cause Concern
Recently, though, there were reports of two different men who took Truvada being diagnosed with HIV. After Dr. Howard Grossman, known for his AIDS and HIV research, announced one man had contracted HIV, headlines took a turn toward dire. Some called it a PrEP failure and that a new HIV strain was the cause.
It didn’t help that the revelation was on the heels of another high-profile case of presumptive PrEP failure. In Canada, one man’s discovery of being HIV positive ruined Truvada’s perfect record of HIV prevention in men. In fact, no one — including clinical trials and studies — had contracted the disease while adhering to the prescribed daily regime before this case.
Unlike those who “disco dose” — only taking Truvada during high-risk times rather than as a daily regimen — the man who contracted HIV in Canada took it every day. He even set an alarm with 10 notifications to make sure he never missed a dose. Once on the drug, he, like many men, had stopped using condoms because of the high success rate of PrEP.
Do These Cases Mean the End of Truvada?
It’s unlikely that these two cases can overwhelm the success of PrEP. An expert in the field, Demetre Daskalakis, explains that this isn’t a crisis, nor is it an emergency. He is the Assistant Commissioner of NYC’s Bureau of HIV/AIDS Prevention and Control and believes the panic is premature.
He explains that with medications up against HIV — medications that people might not be taking like they should — the virus will replicate and perhaps be resistant to those drugs. It’s one of the reasons for resistance testing.
It is a misunderstanding that this is a new strain of HIV resistant to PrEP. Part of that misunderstanding occurs because there is no single strain of HIV — it is a virus that mutates. It’s not that this is a drug-resistant strain. Rather, it’s that there are many strains.
In the most recent case, the man who contracted HIV after adhering to PrEP did so from a strain of the virus different than the HIV strain his partner carries. When the couple engaged in intercourse with couples outside of their partnership, without wearing condoms, they came into contact with a different strain from one of the other partners.
The man with the new HIV diagnoses had been using PrEP to protect against his partner’s strain of HIV, not the new strain he came into contact with.
What Is the Next Step for Those at High-Risk
PrEP without condom use isn’t the best option for those with more than one partner — unless the stats are known for every sexual partner someone has, and that can be a tall order. However, even in these cases where PrEP wasn’t 100%, the outcomes were as positive as they could be. In fact, the man from the October case was treated so fast that the HIV was undetectable immediately.
There are places that offer consolations for men looking to try PrEP as a preventative measure. Educating men about how to ensure the effectiveness of PrEP is crucial to staying healthy.
If you’ve been using Truvada, don’t stop taking it, but use condoms if you don’t know the viral status of your partner. These are isolated cases, and, even without extenuating circumstances, two cases of HIV out of 40,000 U.S. PrEP users are strong numbers.