PrEP use 90% higher than last estimated

Timothy Kincaid

February 4th, 2016

truvadaLast month, AIDS Healthcare Foundation issued a smirking attack on the Centers for Disease Control, mocking the low number of people who are availing themselves of pre-exposure prophylaxis.

“…according to CDC only 21,000 people are on the drug in the United States. Any objective observer has to conclude that most patients don’t want to take Truvada and doctors are not recommending it.”

Although there are dozens of references to this estimate, I have not yet been able to find the source. However most appear to be in November 2015, and use language like “currently” to discuss the number of total participants.

But, irrespective of the exact date in which 21,000 was a valid estimate, it certainly is no longer so. The following is from Gilead’s Quarter Four 2015 conference call which took place on Tuesday:

Public health programs to prevent HIV transmission are also underway, including efforts to raise awareness about the use of Truvada for prep. Today more than 40,000 patients in the US are receiving Truvada for a preventative indication.

In other words, PrEP use is about 90% higher than when last reported/estimated.

I very much doubt that participation doubled in the last two months. Likely, the estimates were based on older data and were understated to begin with.

But I do think that this illustrates something that I’ve observed and which I’ve heard discussed; It appears to me that there is a very sharp upturn in people becoming aware of the benefits of PrEP and choosing to avail themselves of this added protection from HIV. There is a cultural upswell which has changed the issue from fear to hope.

There have been several pivotal moments in the fight against the HIV/AIDS pandemic. The identification of the virus in the 80’s allowed for the first wave of protection, condoms. The discovery of anti-retroviral treatment in the mid 90’s, with it’s every increasing fine-tuning made the fight one about the value of life, not about survival. As viral loads became undetectable, Treatment as Prevention (TasP) became the next wave of protection and transmission prevention.

I believe that PrEP is equally revolutionary. This is the third moment in the fight which we will look back upon as there being a before-PrEP and after-PrEP way of life. This is the first time in the lives of many gay men my age in which there is no longer a component of fear in every sexual encounter.

WayneF

February 4th, 2016

Thank you Timothy for continuing to report on this very critical issue! This is certainly good news to hear. Let’s hope that the numbers continue to increase. I have counseled many people on this particular issue seeking information. Part of the process to obtain PrEP is to undertake an HIV test. This can only help to identify more people who are infected but remain undiagnosed and subsequently not in treatment. By increasing diagnosis and treatment along with TASP (PeP and PrEP) we can stem the rise in new infections.

Priya Lynn

February 5th, 2016

“Any objective observer has to conclude that most patients don’t want to take Truvada and doctors are not recommending it.”

I think more likely people aren’t taking it because doctors are not recommending it, not because they don’t want to take it.

“This is the first time in the lives of many gay men my age in which there is no longer a component of fear in every sexual encounter.”.

For me there’d still be a component of fear in any non-monogamous sexual encounter even with Truvada. But then I am a pessimist.

enough already

February 5th, 2016

Priya,
No, you’re a realist.

Priya Lynn

February 5th, 2016

Thanks EA.

Mark F.

February 5th, 2016

It doesn’t protect against all STDs, just the one that is most dangerous right now

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