The New York Times (11/26,) reported that officials at the Centers for Disease Control and Prevention said last week that about one-third of primary care physicians and nurses in the US have not heard of Truvada (emtricitabine and tenofovir disoproxil fumarate), an HIV pre-exposure prophylaxis drug. According to Dr. Eugene McCray, director of the CDC’s division of HIV prevention, “Providers play a central role in increasing awareness and uptake of PrEP.”
AFP (11/26) reported that CDC Director Tom Frieden, MD, MPH, said, “PrEP isn’t reaching many people who could benefit from it, and many providers remain unaware of its promise.” Dr. Frieden added, “With about 40,000 HIV infections newly diagnosed each year in the US, we need to use all available prevention strategies
Blogfinger medical commentary: By Paul Goldfinger, MD.
There are 40,000 newly diagnosed cases of HIV yearly in the US. Some of those cases could have been prevented with a drug called Truvada, made by Gilead Pharmaceuticals, a company in California.
PrEP means pre-exposure prophylaxis.
The idea is that certain uninfected people are particularly at risk of being infected. High risk groups include gay or bi-sexual males and also drug users who inject narcotics. A small but important at-risk group are the sexual partners of heterosexual adults with HIV. Heterosexuals can get HIV by needle sticks, transfusions or risky sexual relations. These individuals would benefit from daily dosing of Truvada.
This story interests me at several levels. For one, I am appalled, but not surprised, that so many physicians have never heard of this important drug. Too many doctors do not keep up with the latest advances in medicine. That is why, in the age of Google, everyone who is susceptible to certain medical conditions should learn as much about those problems and not depend totally on doctors.
Sex is a delicate topic, and many doctors don’t ask their patients about sexual and lifestyle issues, and they should. How many of you have ever been questioned by your doctor about your lifestyle, and, in particular, about sexual matters such as STD prevention?
And how many uninfected people are in relationships with others who are HIV positive, but don’t know that Truvada exists? That is a tragedy at a personal level and a disgrace for the medical profession.
The profession has done well with some related issues such as quickly treating medical personnel who get stuck with an infected needle. Or providing treatment if a risky situation occurs, such as a broken condom.
Another happy area is that this is the first year in the USA when no baby has been born with HIV, transmitted by the mother. And, many HIV patients take medication which prolongs their lives and brings their viral counts so low that they are practically non-infectious.
These advances are amazing especially when we still do not have a cure or a vaccine for this condition. Prevention is so important, and doctors must pay attention.