AIDS: the United States advocates preventive use of an antiretroviral

US health officials now recommend hundreds of thousands of Americans considered “at risk” for AIDS to take an antiretroviral preventive daily, according to the New York Times.
The initiative from the Centers for Disease Control and Prevention (CDC), the main US government agencies for the protection of public health and public safety, concerns Truvada, the only antiretroviral authorized in 2012 by the Federal Agency. drugs (FDA) as a preventive measure as part of a strategy called PrEP (pre-exposure prophylaxis).

Four risk groups
These new CDC guidelines are aimed at four risk groups: gay men who have sex without a condom, heterosexuals with high-risk partners such as injection drug users, bisexual men who have unprotected sex, and all person who has regular sex with partners known to be HIV positive. Finally, anyone who shares syringes and injects drugs can also fall under this therapeutic indication.
To justify this decision, the authority recalls that recent studies have shown that in men using a condom, Truvada reduces the risk of infection by 44%, for example in the event of a condom breaking. And in heterosexual couples, when one partner is HIV positive, it reduces the risk of infection by 75%.

In addition, the Atlanta CDC also recommends testing before starting treatment, and every three months thereafter. “I think these guidelines from the CDC are a good idea because we need all forms of prevention possible, and this drug is very effective,” said Dr. Anthony Fauci, director of the US National Institute of Allergy and Disease. infectious diseases (NIAID) in an interview with Agence France Presse.

Experts fear a relaxation of condom use
However, some organizations are very critical of the CDC initiative, such as AIDS Healthcare Foundation, America’s largest NGO providing healthcare for people with HIV.
For its president Michael Weinstein, this approach “will lead to a decrease in the use of condoms which is already declining and increase other venereal diseases such as syphilis, which is experiencing a strong resurgence. “
A point of view shared by French experts such as Prof. Jean-François Delfraissy, immunologist since 2005 at the head of the National Agency for Research on AIDS and Hepatitis. “The idea is to add Truvada as a new method of prevention to existing tools, starting with the condom. We are talking to people who take risks in their sexuality but who are not sick. Can we then take preventive treatment all his life that is not devoid of side effects? Is there a risk of slackening in condom use if people feel protected by Truvada? The risk of transmission of the infection is reduced but not zero ”, explained this doctor in July 2012 to why actor.
“This combined prevention strategy also comes at a cost of thousands of euros per year and per person. Should the community pay when less expensive prevention tools are available? These are societal issues that go well beyond medicine, ”he concluded.