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.
“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.”
“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?