We all know PrEP is not a 100% shield against HIV. We were reminded of that when we posted in January of this year Man Taking PrEP Daily Contracts Drug-Resistant HIV and in February Man Who Contracted HIV While On PrEP Speaks Out. Another case has been shared with the world yesterday.
A second man taking the daily HIV-prevention pill Truvada has been infected by a rare drug-resistant strain of the virus. The results were presented by Cleveland Clinic HIV specialist Howard Grossman, who unveiled the finding at the 2016 HIV Research for Prevention conference in Chicago on Tuesday.
The patient, who is not releasing his name or age to protect his privacy, is a gay man who had been taking the drug daily since January 2016. Hair and blood tests confirmed that he had the appropriate blood levels of the pill’s two drugs — tenofovir and emtricitabine — to offer the nearly 99% protection it offers from the virus when taken daily.
The patient’s long-term partner is HIV-positive but on treatment, with an undetectable viral load in his body. On two occasions and with two separate people, however, the couple had condomless sex with a third person.
Grossman found that the patient’s strain of HIV was resistant to both of the drugs in Truvada, as well as all of the other drugs in its class, which work by blocking one of the enzymes needed by the virus to reproduce. The new strain did not match his partner’s, meaning that the multi-drug-resistant virus must have been transmitted during one of the two sexual encounters.
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“We know PrEP is not 100% effective, and that’s something we need to be saying loudly and clearly,” Mitchell Warren, executive director of AVAC, a global HIV-prevention advocacy group in New York City, told BuzzFeed News. “No prevention method — other than abstinence — is.”
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“Truthfully, PrEP is the best intervention we’ve ever had to prevent HIV,” he said. “I don’t think we’re going to see some huge explosion of failures. I think it’s going to be a sort of trickle, if anything.” – buzzfeed.com
Head over to buzzfeed.com to learn more about this second case. Warren said, “We have now seen hundreds of thousands of people on oral PrEP, and we’ve only seen two cases of so-called breakthrough infections.”
Do you think there are more cases out there that we do not know of?
Do you think people on PrEP are continuing the practice of testing themselves for HIV?
Or are PrEP users more apt to test more often?
What do you do?
h/t: buzzfeed.com
a. There are multiple strains
a. There are multiple strains of HIV-1 and PrEP defends against most of the common strains, but there are a few that we don't know how to prevent against at this time. PrEP is not a wonder drug that makes you magically HIV-resistant; it's a security measure for those who are otherwise taking risks that they do not for whatever reason protect against.
b. PrEP is akin to vaccines in that if more people are on PrEP, it makes it safer for the community as a whole in the same way that herd immunity keeps children safe against diseases even if they are not vaccinated. When the population is largely protected, it becomes less likely that those diseases can cultivate and spread. When the protection is reduced, disease gains a foothold and spreads more easily.
c. Just because something doesn't work perfectly doesn't mean we have to chuck it in the bin. If PrEP saves one person from contracting HIV and they then don't pass it on to another partner, you have a lineage of men from that point onward who will not contract HIV that way. Maybe they will somewhere else, but the fewer chances for HIV to propagate, the better for everyone.
d. Public health is a serious issue and requires long game thought, ya snarky Mary.
Well, NOBODY saw this coming,
Well, NOBODY saw this coming, huh? I mean… yeah, that whole thing that happened back in the mid-eighties and all, but THAT was then, and this is NOW. We are so much smarter now… so… so… much smarter. We have… science! But apparently, no common sense or sense of history, at all.
It has never been claimed
It has never been claimed that PrEP is a cure or a 100% preventative for HIV. You should still be using condoms when on it. The fact that they were having unprotected sex with two other people is reckless. If you play with fire, you're gonna get burned at some point.
Three people doesn’t make it
Three people doesn't make it none effective, it could've been the way they take or miss using the drug or a number of other thing and if there are more people then the pharmaceutical companies need to make the drug a little more potent or take a lab test for each individual before you administer them the drug.