HIV Prevention Debate

The suggested approval of a widely used antiretroviral drug to prevent HIV transmission in uninfected people sparks a debate about the possible dangers of such a move.

May 21, 2012
Cristina Luiggi

Scanning electron micrograph of HIV-1 budding (in green) from cultured lymphocyte WIKIMEDIA COMMONS, CDC-C. GOLDSMITH

Earlier this month, an advisory panel for the US Food and Drug Administration (FDA) recommended the approval of the widely used antiretroviral drug Truvada for the prevention of HIV transmission. Although clinical trials of Truvada have demonstrated a 90 percent efficacy in preventing the sexual transmission of HIV when taken daily, ScienceNOW reported, the panel’s decision to approve the drug for use in uninfected people was met with considerable resistance by experts who worry that incorrect use of the drug will lead to risky behavior as well as widespread drug resistance.

"I think it will be a catastrophe for HIV prevention in this country," Michael Weinstein, president of the AIDS Healthcare Foundation and the most vocal opponent of the recent decision, told ABC News. "Men don't need more excuses not to use condoms."

Health officials also worry that failure of people to adhere to the once-daily dose of Truvada will not only result in a lower drug efficacy, but it could lead to massive drug resistance. Nevertheless, others saw the decision in more positive light. “The meeting and vote represent a tremendous milestone for HIV prevention,” Jared Baeten, an epidemiologist at the University of Washington, Seattle, told ScienceNOW.