HIV inhibitor Truvada can help prevent infection. But the pill is too expensive for the developing world and gives a false sense of security.
A prostitute in a see-through miniskirt stands in a disco bar in Bangkok. She says her name is Joy and she wants to take advantage of what is possibly the biggest breakthrough in the fight against AIDS in the past thirty years. The 23-year-old street daisy hopes that the brand new AIDS prevention pill Truvada will prevent her from becoming one of the 530.000 Thais infected with HIV.
"I'm scared," she says, pausing at the bar. 'I want to find a man and get married. If that pill works, I'll take it.'
Truvada has been used for years to treat people with HIV, but was given the green light in the US this week to also be prescribed for prevention. With regular use, the drug reduces the chances of infection by 94 percent, according to manufacturer Gilead Sciences. Now that researchers are failing to develop an AIDS vaccine, a daily pill that stops the virus could be a nice alternative to prevent infection. But how the limited supplies will be distributed is a question that gives prevention workers a headache.
Not ethical, too expensive
'At first glance, it's an astonishing thought: that you can prevent HIV with a pill,' says Kevin Robert Frost of Amfar, an AIDS research foundation. “But when you think about it, it becomes difficult. Who's going to pay for this? In developing countries there is not even money to give this pill to the sick.'
The AIDS virus HIV paralyzes the immune system of those infected with it within a few years without medication. In 2010, such an HIV infection killed 1,8 million people. And of the estimated 15 million infected who needed AIDS drugs, only 6,6 million in developing countries could get them, according to UNAIDS figures.
This weekend, more than 22 activists and researchers will gather in Washington for the international AIDS conference. Now that the travel ban for HIV positive people has been lifted, that meeting will be held in the US for the first time in XNUMX years. A good part of the consultation next week will be about ways to reduce the more than XNUMX infections per day, and what role Truvada can play in areas where prevention is most needed.
François Venter, of the Wits Reproductive Health and HIV Institute in Johannesburg, said he was 'blown off his socks' when he heard two years ago how significantly Truvada reduces the risk of infection. But since then he has prescribed the drug only a few times for prevention, to people who can afford the cost of a course of $ 480 per year (390 euros). In South Africa, 5,6 million people are infected with HIV. One in three lives on less than $2 a day, so the drug is out of reach for most.
The situation is different in the US, where the average income is over $51.000 a year and many people have health insurance. In addition to Truvada, condoms must also be used and people must first be tested to rule out that they are already infected. To set up something like this in Africa and Asia, where no one is insured against illness, would cost billions.
Magic potion
In South Africa, with one in six adults infected, the entire population is at risk of being infected in turn, says Venter. Even at the lowest price, $45 a year, it would cost billions to give Truvada to the XNUMX million uninfected South Africans.
'Large parts of Africa and Asia don't have the money to pay for medicines for people who are already infected,' says Venter. 'Giving prevention priority over treatment is ethically irresponsible and, moreover, not smart for your wallet.'
Gilead does sell Truvada in developing countries at cost price and tolerates the production of white products in India and China. But even if there were suddenly enough money to help everyone at risk of Truvada, AIDS would not be out of the world, says Michel Alary of Université Laval in Québec. 'Not everyone will remember to take a pill every day, which is necessary for it to work. Irregular use not only leads to infection, but also makes the virus resistant to the medication.'
Alary also fears that users may get a false sense of security from Truvada. If people don't use condoms and forget to take a pill now and then, an infection peak could follow, exactly the opposite of what is intended. “Truvada is not a magic bullet,” he says. “This is not a priority for me. If you want to prevent infection among prostitutes, condoms must be your priority.'
Prostitute
Joy, the Bangkok prostitute, says she will have no problem taking her Truvada pill every day. That is different for Din, a 37-year-old male prostitute from the same city. Neither of them want their full name in the newspaper, because of the stigma that comes with it Thailand on sex work. The man took part in a trial to see to what extent prostitutes are willing to take a pill every day to protect themselves against HIV infection. From the trial, accompanied by it Thai Red Cross, it turned out that this was not going so well in his case.
Din has been working in the sex industry since he came to Bangkok from the northern province of Udon Thani eight years ago. He says it bothers him to remember to take a pill every day and he doesn't like to carry the medicine around for fear someone might see it and jump to the wrong conclusions. 'I know that the pill protects against HIV, but it's just not that convenient that I have to take it every day,' says Din, who is not infected and always uses a condom at work.
The World Health Organization (WHO) will develop guidelines on the recommended use of Truvada as a preventive measure among men who have sex with men and in couples in which one member is infected. The WHO does not yet recommend Truvada for use by sex workers.
Source: De Standaard.be
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Known as Khun Peter (62), lives alternately in Apeldoorn and Pattaya. In a relationship with Kanchana for 14 years. Not yet retired, have my own company, something with insurance. Crazy about animals, especially dogs and music.
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Good news, but not as nice as it seems here. The protection of 95% that is mentioned seems very fantastic. In scientific publications, a protection of 44 to 73% is mentioned, and that only with a daily intake. There is also a similar product on the market with partly different side effects. Side effects that can be quite drastic with both drugs. Many recent publications about these resources can be found on Google.nl. By the way, this year is not the first time that the international AIDS conference will be held in the US. That was in 1986 in Washington and in 1987 in San Francisco. Since then, these conferences have indeed no longer taken place in the US for the reasons mentioned above.
There is always brewing around the pot. Isn't it possible now to describe what the symptoms are, of HIV AIDS.
Then a lot of people know whether or not they should see a doctor.
If you can write on this blog, you can also take the trouble to look up the symptoms of HIV / AIDS yourself on the internet?
Rien, if you are in doubt, why don't you go to the doctor right away?
Then you know for sure…
I think it's better than looking for it yourself on the internet.
The low response shows once again how fraught this subject is. It is therefore still a huge taboo. Chapeau, for Doutzen Kroes' TV commercial, who tries to break the taboo on it.
People are afraid to be associated with it, let alone admit it, even though it could happen to anyone. After all, you don't have to be gay or have an affair to contract HIV or Aids. With regard to the transferability and different stages of this disease, the most nonsensical stories are told out of ignorance. HIV is now regarded as a chronic condition in Western countries, with the available knowledge and medication. Similar to diabetes.
Introducing the drug Truvada as a preventive measure can indeed be ethically questioned given the enormous number of infected people and the shortage of that drug. The stated number of 530.000 infected Thais is, in my opinion, much higher. This also in view of the incubation period of 9 to 10 years, before the symptoms can be observed. Many do not know that they are infected and usually only find out by chance.
If you regularly urinate next to the potty, it is advisable to have yourself tested from time to time. You will know the result within 24 hours!