A Drug That Sort of Prevents HIV Transmission: What Could Go Wrong?

​Imagine a drug that could stop the spread of HIV. People could screw whomever they wanted however they wanted and sleep peacefully knowing that the virus wouldn't soon be waging an all-out assault on their immune systems. 

It sounds like a quick fix to one of history's most pressing public health catastrophes. And it isn't a far-fetched possibility. 

The Food and Drug Administration is now deciding whether to approve the first-ever drug for reducing the likelihood of acquiring HIV through sex. But some experts, including Dr. Rebecca Colon of Fort Lauderdale's AHF Northpoint Healthcare Center, have serious concerns that an approval from the FDA may do more harm than good. 

"Depending on what study you look at, it was 44 to 66 percent effective in preventing HIV," Colon says. "If a birth control pill was 44 to 60 percent effective, it would never be approved."

Colon and colleagues from the AIDS Healthcare Foundation are posting up in Washington, D.C., this week so they can voice their concerns to congressional leaders and staffers.

The drug in question is called Truvada, and it's made by California-based Gilead Sciences. The FDA approved it in 2004 as a treatment option for those already infected with the virus. It's a highly effective medication when used in this capacity, Colon says, among the most prescribed drugs for people living with HIV.

But Colon fears that green-lighting Truvada as a preventive measure -- or a "pre-exposure prophylaxis," in medicalese -- could lead some to be a bit more reckless in the bedroom and stop using the always-trusty condom, which happens to be 95 percent effective in preventing the spread of HIV. The Centers for Disease Control and Prevention voiced similar concerns last year, going on to note that harder-to-treat, drug-resistant strains of the virus could emerge from widespread use of Truvada. 

There's also the aspect that we as humans aren't very good at adhering to directions, even when it comes to something simple like taking a pill once a day. 

"Everyone wants to take no pills or as few as possible," Colon says. "When it comes to prevention, if it's inconsistently taken, it's really not effective at all."

Truvada isn't a Flintstones chewable that should be swallowed all willy-nilly after a bowl of Frosted Flakes. Side effects, according to the drug's website, include changes in body fat, liver and kidney problems, and accumulation of acid in the blood. At this point, nobody has any idea what the long-term effects are from taking the drug when not infected with virus.

There's obviously great potential for a drug that can stop the spread of the virus. And although Colon is against a blanket approval for Truvada right now, she acknowledges that it could be beneficial for some, especially those most at risk. 

"I'm going to Washington, D.C., on Monday in hopes of educating our Congress about pre-exposure prophylaxis and hopefully have them understand that this is not likely in the best interest of everyone in the entire country," she says. "This is not a magic pill." 

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Chris Sweeney