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US approval of drug for HIV prevention welcomed cautiously in UK

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  1. This drug has a success rate of only between 44-73%, and that’s if we believe its manufacturer’s research.

    Nothing less than a 100% independently verified success rate should be approved for general use an an HIV preventive measure.

    Failing which we lull an entire new generation of gay men into a false sense of security regarding HIV transmission.

    But what do you expect when the FDA – one of the most corrupt and infiltrated of all public bodies globally and entirely in the pay of pharma lobbyists – is behind this move?

    The FDA has singlehandedly killed millions by approving medicines and drugs known to kill or make people very sick – thereby requiring even more expensive treatments – while going out of its way to demonise natural remedies with centuries of proven efficacy.

    For the NAT to describe this as “exciting news” merely reinforces the extent to which the UK HIV sector has allowed itself to become influenced – and at worst bought and paid for – by corporate interests.

    1. “100% independently verified success rate”

      Show’s how little you really know about pharmacy if you think 100% success rate is a reality.

      Fool.

      Why not blame the PC Brigade or the Tooth Fairy (or what ever delusion is this weeks fancy) for it all, eh?

      1. Why don’t you actually bother reading what I have written before being so quick to jump off your leash and bare your teeth?

        I am saying that Truvada should not be allowed for general use as it does not have 100% efficacy, which is entirely the point.

        Otherwise we commit a new generation into playing Russian Roulette with their health, only this time on the toss of a pill which may well damage their kidneys and increase their susceptibility to full-blown Aids if and when they do acquire the virus.

        And at £9000 for a year’s supply, is that a price we are willing to pay for encouraging recklessness at the expense of our brethren’s health when one decent, impactful HIV campaign could reduce far more onward transmission at a fraction of the price?

        Oops sorry, we don’t do old-fashioned campaigns any more, do we, because there are no pharma backhanders and perks in that approach, only in singing up their pill-popping “prevention” strategies.

        Now, back in your kennel, there’s a good boy.

        1. Look, we all know you’re a ranting fool. Seriously, do you expect people to “debate” with you? You’re a crass and stupid individual and you see conspiracy theories everywhere, probably due to a mental health issues or simple to make you feel important.

          Either way, I don’t care about your waffling rants, other then to amuse myself at your expense, they have no bearing in reality. This view is universally shared across this site.

          So, run along pops, the good doctors have stuffed your ice cream with Lithium for dinner!

          1. Harsh……….but so true David, & nothing I havn’t said myself in respect of Samuel!

          2. LOL, look who’s ranting and waffling!!

            A universal view shared by you and W6?

            Oh pur-leeeeease, that is the funniest thing I’ve heard, like, evah!!!

            That you have neither the intellect nor the decorum to debate in a grown-up manner manifests in your unfettered bitterness aimed at those who do.

            And remember, it is the likes of me who taught W6 how to debate using clever words like “stymie”, so who are you kidding?

            Hoist by your own petard methinks, so slobber back into your kennel before I alert the good folk at Battersea that there’s a snarling, rabid rottweiler on the loose, there’s a good boy.

          3. …….it has to be said Samuel does have a very good command of the English Oxford Dictionary – sadly I feel that he uses “posh” words to distract from his lack of knowledge in the areas he posts about. I can name many contributors that feel the same about you Samuel, & another contributor has confirmed that he has felt bullied by you, so I do beleive it is time for you to have a reality check.

            It is also noticable that sometimes you are able to post with restraint & make some interesting points, but this usually gives way to your trademark insults, use of provocative words & generally being unpleasent. This has clearly been demonstrated in this particular thread.

            If you took time to research the subject matter relating to HIV then perhaps there could be reasoned debate – but you have the default setting of taking the AIDS Inc view as gospel, when it is just the view of one or two individuals who have “cherry picked” quotes to suit a particular argument.

          4. Now this particular thread is about the use of Truvada as PrEP so rather than be further distracted perhaps you can show you are able to debate the subject matter Samuel!

  2. this is going to lead to a new rise in transmission cases because of the ignorance around HIV STILL in the UK – people will assume that they can pop a PrEP before sex – and the press who still get transmission reporting wrong will over simplify this drug and no one will listen – until the statistics show an overwhelming increase in new infections – then all those ignorant ‘blamers’ will turn on NAT THT and other organisations who get the blame for trying against all hope to educate sexually active men and women.

    USE a Condom – raw ain’t worth the risk!

    1. Yes, prescribing Truvada as a preventive treatment for HIV infection will, of course, only succeed in increasing HIV Infection rates, JD, and I jolly well hop all those ignorant “blamers” DO turn on NAT and THT for not having the backbone of the Aids Healthcare Foundation in the US by singing up its obvious disadvantages and the severe health risks this drug poses.

      The NAT and THT by their (complicit?) failure/refusal to state the facts about Truvada as prevention treatment are slowly beating the drums for its general use in the UK.

      Well may the excrement hit the proverbial fan if and when it finally does!

      1. What are the facts about Truvada that you want to be clarified in relation to PrEP Samuel? There is a plethera of evidence about the use of this particular drug, perhaps you should take time to investigate this.

        In addition the UK will be commencing trials using Truvada as PrEP this coming Autumn. The trial, called PROUD, (Pre-exposure Option for Preventing HIV in the UK), is a collaboration between the Medical Research Council and the Health Protection Agency. I do not see NAT or THT mentioned in this collaboration. I think you deliberately overstate the influence HIV charities have on drug trials in the UK – clinicians prescribe drugs not charities; charities lobby Governments for improved resources / research – there is a big difference, clearly one you either fail to understand or just do not wish to acknowledge.

        1. ……….and just as a post script about THT – which will no doubt stick in the gullet of the likes of Samuel.

          THT have been awarded a 3 year contract totalling nearly £7 million to carry out an England wide HIV prevention programme until 2015. I wonder what went wrong with the Status Prevention bid for this contract???? Perhaps they have not got the resources or drive to have even put a bid in (they don’t seem to be doing anything at all these days)!

          http://mediacentre.dh.gov.uk/2012/07/23/8-million-invested-to-tackle-hiv-and-improve-sexual-health/

          This is good news as this will secure funding to build on the work already undertaken by THT & its partners – so much for THT et al for being in jeapardy in terms of funding as Samuel would like us all to beleive, I bet you are gutted Samuel – you should right to your MP and hold the DoH to acount me thinks, galvanise your army of supporters!

  3. The sooner we get Truvada approved as PrEP the better. It should be delivered alongside a comprehensive range of other health promotion initiatives rather than as a standalone biomedical intervention.

  4. Yeah…for the USA!!!!!
    At least they are trying to do something.
    What’s the UK doing?
    What ever it is, from what I see in the community of men who like men, it’s not working.

  5. So let’s get this straight:-

    The National AIDS Trust last week advocated the general use of unsafe HIV home-testing kits against a chorus of condemnation on these boards, with one loan exception (ie. W6_Bloke).

    This week the NAT describes as “exciting” the US FDA approval of a pill with a non-100% success rate at preventing HIV transmission.

    So in the NAT’s deluded world it welcomes a future in which gay men will be popping unsafe pills and then testing their HIV status at home on unsafe testing kits…

    On that basis alone, Deborah Jack and co. you are a complete and utter disgrace and danger to gay men and all those who partner with HIV individuals and deserve to have your charitable status revoked forthwith.

    1. For the benefit of other contributors I should like to confirm that I raised questions with NAT about the HIV Home Testing Kits Samuel refers to & I have received a response that clearly confirms their position in relation to home testing kits, which is in keeping with their previous publications on this subject area. I am satisfied that NAT have not received any financial incentive or intend to receive any financial benefit from the manufacturers of the OraQuick test.

      NAT firmly beleive that home testing as a concept should be further explored in the UK, and they have clearly assured me that they do not endorse any particular product, as was suggested in the story as it appeared in PN, & how it was perceived by the “chorus of condemnation” 3 maybe 4 contributors.

      I take the time to ask appropriate questions where there is any doubt in my mind about a particular issue – to me this is a sensible approach to take.

  6. It is important to understand the context in which Truvada will be used as PrEP, which will be different across population groups – something that is often misrepresented or poorly understood, thus:

    1. PrEP provides the opportunity for a hetrosexual couple to conceive naturally where one partner is +ve, this has to be a good thing in my view.

    2. PrEP will help hetrosexual women belonging to certain at risk groups to remain safe where their partner is +ve & they are not always in control of condom use.

    3. PrEP can help gay couples over come the fear of HIV transmission where one partner is +ve – this is particularly the case where treatment it not clinically indicated in the +ve partner.

    4. PrEP can help those at the high end of the risk spectrum to remain HIV negative.

    I am very pleased that we are not as yet following in the footstpes of the US & we will be conducting controlled high quality trials to add to the available evidence on the use of Truvada as PrEP in the UK.

    1. the use of Truvada needs to be further studied because of concerns about drug resistance developing in those taking it, which could have serious consequences as Truvada is one of two recommended drug backbones that is used alongside current HIV treatment regimens. In addition further study is required on the monitoring of those individuals taking Truvada as PrEP. We know that the Tenofovir in Truvada has been likned to kidney toxicity & possibily changes in bone density – those on full HIV treatment are well monitored for these risks, but we need to have a clear & robust policy in place regarding monitoring & follow up.

      I beleive it is wrong to suggest that Truvada will be available to all – as mentioned above there are particualr risk groups that PrEP can work for. I firmly beleive that for MSM who are at the greatest risk of contracting HIV PrEP will only work alongside other measures such as in depth counselling, and other interventions – PrEP alone will not solve these problems…

      1. ….but it may help keep at risk groups safe whilst they are dealing with other issues that impact on their ability to engage in safer sex. It is often suggested that Post Exposure Profalaxis (PEP) is readily available & is used as “the morning after pill”. Anyone who has wanted to access to PEP will know that it is not easily given out because of the difficulties surrounding adherence & side effects – these often outweigh the perceived risk of infection. I beleive that the same safeguards (& more) will be applied to the use of Truvada if it is eventually licenced for use in the UK.

        There are concerns that need to be addressed, but HIV charities such as NAT & THT are right to lobby the Government to further research this additional preventative measure. We need a variety of approaches to prevention because we are all different & respond differently. I look forward to the results that come from the UK study which will start in the Autumn.

  7. This is a great step forward. The more ways we have of preventing HIV infection the better.
    However I suspect that this will not be for everyone. I personally wouldn’t use it but it should be available for those who find it difficult to use condoms every time.
    Given the cost of this intervention I suspect that it will be strictly rationed to those who really need it.

    1. I agree with your comments John & I beleive that it would be wrong for PrEP to be available to “anyone” because close monitoring will be required particularly in relation to adherence & potential side effects. I would not want to see lifelong Truvada usage, as is the current situation with full HIV treatment.

      Cost will be a big issue & this alone will mean that Truvada will only be provided either for short courses, perhaps in the case of couples wanting to conceive naturally, or MSM where the +ve partner is not clinincally indicated for treatment. With those who are at the highest level of risk then a great deal of emotional & psychological support will be required to help behaviour change occur – PrEP can provide that vital “safety net” when high risk individuals are seeking such help with regard to behaviour change.

      We should not regard PrEP as an alternative to condom use but as an enhancement to safety & this has been clearly stated by the likes of NAT & THT.

  8. Jock S. Trap 17 Jul 2012, 6:42pm

    Prevention is cheaper in the long run but I do worry some will use this as an excuse not to look after themselves and others. Therefore putting themselves at risk more.

    We most importantly need proper education in schools and better awareness elsewhere.

  9. How did we ever reach this point where HIV Charities now sing up pill-popping as HIV prevention (pre and post exposure)?

    I geddit:- there’s no monetary incentive in the old-fashioned method of HIV prevention where a little shock and awe was employed to encourage us to always wear condoms.

    And shame on PN for jumping on the NAT bandwagon and not reporting the full picture.

    According to my Guardian, the NAT’s US counterpart The Aids Healthcare Foundation has come down on the FDA for their ruling like a ton of bricks, describing it as “a reckless move that will ultimately set back years of HIV prevention efforts,” and citing evidence that Truvada can cause kidney damage.

    And notwithstanding its annual cost of £9000, which represents a nice little earner for its manufacturer.

    Th AHF also pointed out Truvada should not be prescribed without an HIV test to ensure the taker is not already affected with HIV:- otherwise the virus could become resistant to the drug…

    1. Which kinda defeats the purpose of prescribing it in the first place!

      The eminently more sensible AHF – which HASN’T been bought or corrupted and puts our heavily conflicted HIV sector to shame – also had the courage to say:-

      “From the beginning we believe there was a rush to judgment by government officials and others in favour of such approval despite decidedly mixed studies offered in support.

      “The FDA’s move today is negligence bordering the equivalence of malpractice which will sadly result in new infections, drug resistance and serious side effects among many, many people.”

      So there we have it:- negligence and malpractice are steering HIV prevention policy in the US, and the UK HIV sector has the impudence to describe the move as “exciting”.

      Of course NAT and THT don’t come right out at this point and call for the adoption of Truvada as a weapon in the fight against HIV, they wouldn’t be so blatant.

      But here begins the covert push by stealth to ensure it does, eventually.

      1. Having a good old rant today Sam? NHS forgot to deliver your meds, eh?

        Do you actually think you know what you’re talking about? Seriously, do you?

  10. I beleive it is incorrect to make a comparison between NAT which is a UK charity and the Aids Healthcare Foundation which is a not for profit healthcare provider in the US. The two organisations have very different roles & therefore cannot be compared as has been suggested in this particular thread.

    We should also note that the UK has not followed the FDA decision precisely because of the difficulties highlighted in the Guardian article.

    We should await the outcomes of the UK trial which is due to start this coming Autumn before we make assumptions on if / how Truvada as PrEP will be used in the UK.

    Making assumptions at this point is not particularly helpful in my opinion

  11. My only concern is the side effects that this drug has.

    Like all HIV meds, which are very toxic.

    Healthy gay men taking this pill for a long period of time (over a few years maybe)
    and what impact does it have on your vital organs (kidney, liver etc)

    Needs further testing in this area to reassure me.

    1. All ingested chemicals are potentially toxic to the body, this ranges from Aspirin to drugs used for chemotherapy. Tenofovir, which is one of the two drugs in Truvada is known to be potentially toxic to the kidneys; this has been known about for some time & there are clear clinical guidelines established in the UK for the management of anyone taking Truvada as part of their HIV treatment. I would agree that this is an area that will require further protocols to be established where an individual is given Truvada for the use as PrEP- these individuals will require close monitoring & follow-up.

      Modern 2nd generation HIV meds should not be described as very toxic – many many people up & down the country rely on taking a lifetime of medications to provide them with a good quality of life & to keep them healthy; HIV medications are no different to those used to manage cardiovascular disease, mental illness, pain management – they all have the potential to be toxic in some individuals.

      1. I could not argue with any of that.

        A very reasonable assessment, W6.

  12. Pharma companies get a bad press – they are associated with big bucks, I get it. My problem is that where would we be without the drugs companies in relation to any illness or health condition, but specifically with HIV drugs.

    I am very sure that there are not many gay men who would want to re-live the 1980’s where there was a mystery illness that could not be clinically managed & death was only a matter of months or at best years away – are we really saying that this situation should have been allowed to continue?

    Had the pharma companies not taken up the challenge, where would be today? Possibly HIV may have run its course, with many many more millions of individuals dying a very undignified, painful death & health resources stretched to the limit.

    I think it is safe to say that gay men would be villified & treated like lepers, possibly imprisoned or segregated from the rest of the population & clearly identified as a biohazard – do we really want to go back to the dark ages?

    1. We undoubtedly owe a good deal of gratitude to the pharmas, W6, but these things work both ways.

      While we are beholden to them we are also dependent on them.

      And while there are – albeit often smaller – pharmas out there who are driven by their humanity as much as a need to be seen as a business turning over a healthy profit, many of the larger corporations are clearly driven by market forces and the need to appease shareholders, etc.

      It is quite right to state that they take advantage of their monopolies in ways that are often disadvantageous to the public, as the massive $3 billion fine GSK was hit with last week in the US testified.

      Pharmas have nowadays come to be regarded as a necessary evil:- we can’t live without them and, as hundreds of thousands who have died as a result of consuming pharma drugs learned, many of us can’t even live with them.

      Today the public is regarded as potential pill dispensers first, human beings second.

      1. I do not particularly agree with your full analysis, but we do live in a market driven economy and sadly big business is the way of the world. Blue sky thinking is all very good & to be admired but I am a very practical individual & things like the market driven capitalist system are way out of my circle of influence. I try to stick to areas that I can & do have some influence over.

        I think it is fair to say that the approach to medications in the States is very different to here in the UK. I do not yet see the UK population as a pill popping nation, we certainly do not have the addiction that the US seems to have with prescription & over the counter medications / medicines.

        It is obvious that Gilead who market Truvada as a PrEP agent have been looking for a new use for the drug as this will enable the patent to be extended – if it does have a value in prevention we should not deny its use based on commercial decisions alone.

        1. Had the pharma companies not taken up the challenge to turn the AIDS Epidemic into a multi-billion dollar industry, you mean?

          I would love to think they were driven by an innate, conscionable desire to prevent the suffering of untold numbers of gay men, Haitians and haemophiliacs, but the cynic in me won’t let me somehow…

  13. Don Harrison 27 Jul 2012, 9:48pm

    I hope that this drug think that people not feel that you do not need to worry ab out “SAFE SEX” any more

    1. I see more and more guys taking risks by not using condoms and more guys not disclosing their HIV status. Surely this drug can only be a better thing for us (excluding side effects) and I also understand in the latest tests of it its proving a 98 to 99% effective if taken 7 days a week. (the same as condoms)

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