- Almost 60,000 people in Los Angeles (LA) county are HIV-infected, with roughly 1,850 new infections occuring each year. Most of those affected are low-income gay and bisexual men of color.
- According to clinical data, preventive Truvada (tenofovir/emtricitabane), which is manufactured by Gilead, can reduce the risk of HIV infection by as much as 92% in at-risk men.
- In 2012, Truvada (which was originally approved as a treament for HIV) was approved for the preventon of HIV.
Clearly the decision to distribute preventive Truvada, also known as pre-exposure prophylaxis (PrEP), is a public health strategy. In many ways, this is exactly the way thhat PrEP is intended to be used---as a way to avert HIV infection in at-risk individuals. Although most HIV prevention advocates are in factor of the move, others aren't.
Last summer, BioPharma Dive covered reactions to the approval and use of PrEP from various stakeholders and wondered out loud why uptake was so meager two years post-approval. It was deemed a good decision in long-term pharmacoeconomic terms by many, though the annual costs, which run as high as $15,000, were a source of concern for those whose insurance plans would not cover PrEP treament. However, compared with lifelong HIV, and an average annual treatment cost of roughly $23,000 for those infected, the costs may be manageable.
But there's another side: Some HIV prevention advocates, including Michael Weinstein, AIDS Healthcare Foundation President, disagree with the use of PrEP, saying that it discourages condom use and condones irresponsible sexual practices.
Regardless, L.A. county is moving forward with its PrEP plan and will eventually have enough data on outcomes to make an interesting case study—and maybe even influence policy.