New HIV Drug Regimen Needs More Research, But Holds Promise

Local experts say a promising new drug regimen to fight HIV-AIDS could help prevent the virus from spreading -- and is one of the most positive developments in years.

Long-awaited results from a three-year, four-continent drug trial were released this week and published in the New England Journal of Medicine. Wafaa el-Sadr from Columbia University's Mailman School of Public Health says the new drug, called Truvada, is "absolutely ground-breaking."

“It demonstrates how using an anti-HIV medication as a pill can actually prevent HIV infection,” said el-Sadr, the director of Mailman’s International Center for AIDS Care and Treatment Programs.

Since the 1990s, a group of drugs called anti-retrovirals has helped stop HIV infections from becoming the death sentence that is full-blown AIDS. But anti-retrovirals, for the most part, don't prevent people from HIV infections in the first place -- although for years, there has been some limited use of antri-retrovirals as a prophylactic, when people have been exposed to HIV.

The New England Journal report was from a three-year drug trial enlisting 2,500 men in six countries. Truvada was 90 percent effective in men who took it consistently. Marjorie Hill, of Gay Men's Health Crisis, says Truvada could be an important new tool for fighting the spread of HIV, but no one should think it's a panacea.

“It is not a cure. It is not a vaccine,” Hill said. “Safer sex practices and condoms continue to be an important part of HIV prevention."

Healthcare providers and local agencies like the City Health Department are waiting for further guidance on Truvada from the U.S. Centers for Disease Control.

One concern is that some people who take Truvada may feel they can have unprotected sex. Blayne Cutler from the City Health Department says that mostly didn't happen among participants in the drug trial.

“However, this is a very controlled setting in the context of a study. Obviously, we don't know what would happen, obviously, in a real-world situation,” Cutler said.

Other concerns include the possibility of drug resistance if it's used too widely and Truvada's high price tag. It can cost up to $14,000 a year, not including all the ongoing testing and support needed to make it work most effectively.

Other concerns about Truvada include possible side effects and the limited population it was tested on, men who have sex with men.

In addition, the drug's target group includes people who don't consistently use condoms. Researchers aren't sure they'll consistently take a pill to prevent a disease they don't have -- when it's already tough to get many people who have the disease to take the medication for treating it.