A New Weapon Against HIV?

A new study indicating that antiretroviral medication is effective in preventing HIV may be raising as many questions as it has answered.

Among them: Who will pay for it? Who should take it? And will it lead to less condom use among gay men?

“It’s an incredible biologic success with incredible behavior challenges,” Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said of the study, published Tuesday in The New England Journal of Medicine.


Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation and involving nearly 2,500 gay men — as well as transgender women who have sex with men — the three-year study found that those who were given the antiretroviral pill Truvada were 44% less likely to become infected with HIV than those who received a placebo.

When participants took the medication as directed 90% of the time — verified through blood tests —Truvada was 73% effective in preventing infection. All study subjects received HIV testing and safer-sex counseling every four weeks.

Though “pre-exposure prophylaxis,” or PrEP, is not new, the study is the first large-scale look at a prevention method that is expensive and unavailable to many.

White House officials quickly praised the study results as encouraging, though hardly a replacement for established methods of HIV prevention, including proper condom use. In a statement to The Advocate, Jeffrey S. Crowley, director of the White House Office of National AIDS Policy, said that further research on PrEP must include women and other groups.

“ONAP recognizes that one study is not definitive and this single study was focused on one population,” Crowley said.

Researchers at the National Institutes of Health, the Centers for Disease Control and Prevention, and the U.S. Agency for International Development “have been active participants in a global effort to examine this issue in different populations and answer other critical questions in order for us to know how to use these findings as part of a comprehensive, evidence-based approach to HIV prevention,” Crowley added.