Why so little uptake of preventive Truvada in the at-risk gay community?
- When Truvada (tenofovir/emtricitabine) was approved for preventive use of HIV infection in 2012, it was hailed as major game-changer. But almost 50,000 people are still becoming HIV-infected each year—and 60% are gay men.
- Truvada was first approved for treatment of HIV in 2004 and generated $1.79 billion in sales in 2014.
- Between January 2012 and March 2014, a total of 3.3 million Truvada prescriptions were written in the U.S. Yet only 3,200 were for prevention, Bloomberg reports.
Comments from HIV/AIDS advocates and Gilead spokespeople highlight some of the problems surrounding the use of Truvada as pre-exposure prophylaxis (PrEP). For instance, Jim Pickett, director of prevention advocacy and gay men’s health at the AIDS Foundation of Chicago, told Bloomberg that patients pursuing PrEP face a landscape where "HIV specialists are like, 'I don’t see HIV-negative people,' and you see a primary care physician, and they say, 'You need to see a specialist.'"
On the other hand, Gilead doesn't see much of a profit motivation in a purely preventative regimen and "does not view PrEP as a commercial opportunity and is not conducting marketing activities around Truvada as PrEP," according to a company spokesperson. The company does encourage patient and at-risk community education—but as Pickett points out, that doesn't necessarily help if other healthcare players refuse to embrace Truvada as PrEP.