Philly on front lines of HIV prevention with guidelines for pre-exposure drug

    The Centers for Disease Control and Prevention, or CDC, has issued new recommendations urging people at risk for contracting HIV to take a medication that could reduce the odds of infection.

    When taken pro-actively, the combination drug Truvada has been shown to greatly reduce the chances of acquiring HIV. The CDC now recommends that healthy people who are at higher risk for HIV take the drug. That includes those who have HIV-positive sex partners and those who inject drugs and share equipment (such as needles). The approach is known as pre-exposure prophylaxi, or PrEP.

    The guidelines are already creating a buzz in Philadelphia’s HIV community. Jane Shull, director of the area’s largest AIDS service organization, Philadelphia FIGHT, welcomed the new guidelines.

    “We have a way that we can prevent people from getting a disease from which there is no cure, although there’s now treatment,” Shull said. “I think that [this drug] should be as widely available as it possibly can be so that people have an opportunity to take it.”

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    Philadelphia FIGHT actually started administering the drug, accompanied by counseling, to high-risk individuals last year. Shull says the response has been “very positive.”

    Some AIDS advocates have criticized the drug as too expensive, costing about $15,000 a year in the U.S. That may be a hard sell for someone who’s not sick, said Kate Krauss with the Philadelphia-based AIDS Policy Project.

    “What happens if their money runs out, what will they do?” asked Krauss.

    Shull said Medicaid in Pennsylvania appears to be covering the drug.

    Krauss, meanwhile, views PrEP as an important approach, especially among groups where HIV prevalence is high and other “preventative measures have not been working well,” but she she added that the strategy is one of many that can help curb the spread of HIV. Other approaches include improving access to condoms, clean needles and stable housing.

    The CDC has selected Philadelphia as a future site to examine the impact and effectiveness of the new guidelines.

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