Scientists have found that a pill used to treat HIV infection turns out to be a powerful weapon in protecting healthy gay men from catching the virus, according to a global study.
Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services. Men who took their pills most faithfully had even more protection, up to 73 percent.
Researchers had feared the pills might give a false sense of security and make men less likely to use condoms or to limit their partners, but the opposite happened — risky sex declined.
The results are “a major advance” that can help curb the epidemic in gay men, said Dr. Kevin Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and Prevention. But he warned that they may not apply to people exposed to HIV through male-female sex, drug use or other ways. Studies in those groups are under way now.
The news came as UNAIDS announced that the global epidemic was slowing – new cases dropped nearly 20 percent over the last decade and about 33 million people are living with HIV now.
Health officials credit part of the decline to wider condom use, and on Tuesday the Vatican said that using a condom is a lesser evil than infecting a sexual partner with HIV, further expanding what some see as Pope Benedict XVI’s softening stance on this issue.
“This is a great day in the fight against AIDS — a major milestone,” said a statement from Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition, a nonprofit group that works on HIV prevention.
Because Truvada is on the market, the CDC is rushing to develop guidelines for doctors using it for HIV prevention, and urged people to wait until those are ready.
“It’s not time for gay and bisexual men to throw out their condoms,” Fenton said. The pill “should never be seen as a first line of defense against HIV.”
As a practical matter, price could limit use. The pills cost from $5,000 to $14,000 a year in the United States, but only 39 cents a day in some poor countries where they are sold in generic form.
Whether insurers or government health programs should pay for them is one of the issues to be sorted out, and cost-effectiveness analyses should help, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“This is an exciting finding,” but it “is only one study in one specific study population,” so its effect on others is unknown, Fauci said.
His institute sponsored the study with the Bill & Melinda Gates Foundation. Results were reported at a news conference Tuesday and published online by the New England Journal of Medicine.
