PrEP Pill Protects Against HIV, Does It Also Promote Condom Disuse?
The PrEP pill has proven to be a vital and successful tool in the fight against HIV/AIDS, helping to protect thousands against the deadly virus. However, does the anti-HIV medication promote risky sexual behaviors and the disuse of condoms?
Kaiser Permanente San Francisco Medical Center held a 32-month study that found PrEP (pre-exposure prophylaxis), an HIV-prevention treatment program that utilizes the drug Truvada, has been of benefit to HIV-negative sexually active gay men who use the pill, evident by the fact that no new cases of HIV have been reported.
The Kaiser study is the first to analyze the effectiveness of the drug following the clinical trials, which provoked the U.S. Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) to endorse the pill for use among all at-risk individuals, mainly HIV-negative individuals who knowingly sexually engage with HIV-positive partners.
HIV, according to the CDC, disproportionately affects the Hispanic community. In 2010, it was estimated that new HIV rates for U.S. Hispanics were three times higher than rates for non-Hispanic whites, and Hispanics accounted for 21 percent of all new HIV infections in the U.S. Additionally, in 2010, Latino men accounted for 87 percent of new cases. Language barriers, poverty and socioeconomic factors often contribute to high HIV infection rates among Hispanics.
An estimated 1-in-36 Hispanic/Latino men and 1-in-106 Hispanic/Latino women will be diagnosed with HIV each year. Eighty-one percent of HIV diagnoses among U.S. Hispanics can be attributed to male-to-male sexual contact, although behavioral risk factors differ by country of origin. In contrast, 86 percent of contractions among U.S. Hispanic women were the product of heterosexual contact. By 2013, HIV was the seventh leading cause of death among U.S. Hispanics. Also, Hispanics have the third highest rate of STDs including syphilis, chlamydia and gonorrhea.
The results, published in the journal Clinical Infectious Diseases, are promising. The study's researchers followed the progress of 657 individuals. 99 percent were sexually active men who have sex with men. They were an average age of 37, and not all participants used condoms. Participants used Truvada for an average of 7.5 months, reducing the risks of developing HIV.
Nonetheless, critics of PrEP suggested that the drug will deter condom usage, thereby heightening the contraction of other STDs. This claim was actually confirmed by study researchers, who indicated that within six months instances of STDs jumped from 30 percent to 50 percent with the exception of HIV.
Additionally, condom use has not changed dramatically, although it did dip among PrEP users. Forty-one percent said they decreased their use of condoms, while 51 percent said their use was unchanged. Also, 74 percent of participants stated there was no change in the number sexual partners, while 11 percent increased the number of sexual partners.
Julia Marcus, study co-author, told HIVPlusMag that the researchers are unsure if STI rates were higher without the use of PrEP because they didn't employ a control group. She also shared that important parts of PrEP treatment are ongoing screening and the treatment of STIs, including hepatitis C.
PrEP is an effective part of HIV prevention strategies, but it has faced the same stigma that birth control faced in its early years, specifically in relation to sexual behaviors. Advocates have begun to push for greater access to the drug for low-income people and people of color. PrEP has been stigmatized, much like HIV testing and treatment has been. Many Hispanics resist HIV services because of immigration status, stigma, fear of discrimination, traditional gender roles and shame surrounding homosexuality.
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