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Trying a Pill to Prevent HIV
01-21-2009, 03:17 PM,
#1
Trying a Pill to Prevent HIV

Trying a Pill to Prevent HIV
Worldwide Trials of Drug to Stem HIV Infections Raises Behavioral Questions
By LAUREN COX
ABC News Medical Unit
Jan. 20, 2009



In a massive medical trial on three continents, doctors are testing a controversial pill that could temporarily boost immunity against HIV before a person is even exposed to the virus. If the pill works safely, doctors must then address whether such a drug, if made widely available, could actually worsen the AIDS epidemic.
pills hiv
A new pill might prevent exposure to HIV before sex, but it must pass behavioral risk tests as well as medical efficacy before it reaches the public.
(Getty/ABC News)
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The pre-exposure pill undergoing testing seems promising, since HIV drugs taken within days after exposure to the virus have been shown to reduce the risk of infection by 80 percent. But public health officials debate whether people at high risk for the virus, such as men who have sex with men, would be more likely to set aside the use of condoms to instead rely on a drug regimen that doesn't provide full protection against the disease, which is spread by contact with the blood or semen of an infected person.

Dennis, a 47-year-old gay man from Atlanta, is one of the test subjects for the new pill. He calls himself "blessed" for escaping the HIV epidemic that hit many of his friends in the 1980s. But his HIV-negative status hasn't stopped him from having sex with infected partners.
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"If you just say that you're not going to have sex with anyone who's HIV positive , here you're eliminating a whole bunch of wonderful people," said Dennis, who asked that his last name be withheld. "How shallow would that be?"

He was recruited for the clinical trial for PreP, or pre-exposure prophylaxis for HIV prevention, with a drug called tenofovir.

"I was eager to take it," said Dennis. Since he was already using condoms, he said, "It couldn't hurt. I'll know in June if I was taking the real McCoy, or if it was the fake pill."

Soon after he started the trial, he noticed the doctors were trying to study his behavior as much as the drug's side effects. Each time he went for a monthly checkup, HIV test and counseling, Dennis said the director of the study, Lynwood Miller at the AIDS Research Consortium of Atlanta, kept asking him about his sex practices.

"I don't think I was any more promiscuous just because I was taking the drug," he said. "I didn't put myself at risk just to test the drug. I'm not that crazy."

Behavior Could Determine Fate of HIV Drug

But doctors worry that others who are at risk for HIV might well put aside their condoms for unprotected sex -- relying on the partial protection of the drug.

The stakes are high in terms of human lives and health costs. Statistics released by the Centers for Disease Control and Prevention in mid-2008 show that in 2006 some 56,000 new cases of HIV infections were reported in the United States, and 1.1 million people have HIV, 25 percent of whom don't know they have it. Worldwide, some 33 million people are infected and 25 million have died of the disease.

Doctors in the trial say they are acutely aware of the possibility the drug may be misused.


"There have been reports that people may be using PreP out in the community even before it was in trial," said Dr. Albert Liu, director of HIV prevention intervention studies at the San Francisco Department of Public Health.

So Liu and his colleagues decided to investigate. They did studies in San Francisco, traveled to large "circuit parties" in Palm Springs, Calif., and San Diego, where gay and bisexual men go to dance and have sex on weekends.

Liu said out of 1,800 men questioned, 16 percent had not even heard of using antiretroviral drugs to prevent HIV transmission, and 1 percent admitted to ever trying them on their own.

A similar study of more than 227 men in Boston, from the Fenway Community Health Center, found one person who had tried using PreP in place of a condom.

While those numbers seem low, doctors, HIV activists and public health officials believe that the number of people using PreP as an ill-advised condom replacement would grow with an FDA approval of a PreP regimen.

Can Drugs Do More Harm Than Good?

"The problem with it is the idea of a disinhibitor," said Sean Strub, founder of POZ magazine (http://www.poz.com/).

"I think of it more in terms of Gardasil and also, even birth control," said Strub. "Virtually every woman who becomes pregnant and did not want to be knows how to avoid it. It's applying that knowledge at the moment of sexual interaction that gets complicated."

Just as with many drugs or treatments that protect against risk, activists and doctors must evaluate whether people will gamble with semi-effective protection and further spread more disease than if they'd never had access to the protection in the first place.

But Strub, who had heard about the possibility of PreP years ago, said the public could also encourage safe-sex advances.

"Quite frankly, it surprises me that people aren't doing this," he said. "Most of the major advances of HIV prevention have not come from the CDC or the doctors or the government. It comes from the community."

HIV Protection and Epidemic

Strub said this year marks the 26th anniversary of a pamphlet "How to Have Safe Sex in an Epidemic," first calling for the use of condoms to protect against HIV, written by community activists. Since that time, controversial additional behaviors, such as serosorting (restricting partners to your HIV status) have evolved.

But unlike the condom, a pre-exposure pill comes with many more nagging medical details.


"The important thing to realize is that it's not just an evening-before pill that people pop," said Liu, who is currently directing the Prepare trial of a combination drug called Truvada among 3,000 men in the United States, South America, Asia and Africa.

Liu said the current testing is for a daily pill, one that may have side effects of liver or kidney damage. Moreover, people in the study need routine HIV testing and follow-up care.

"These are men who are at risk for HIV, and since we don't know yet whether this approach works, we want to keep them on the best prevention," he said.

Costs of the drug may also be an issue.

"The medications that are involved are costly, and depending on whose paying for them, different payers or insurance, it could be a problem," said Dana Van Goder, executive director of Project Inform, a community-based HIV/AIDS awareness program in San Francisco.

Van Goder estimates the drugs, as they are sold now, would cost $500 to $900 a month. That would presumably go down if the drugs were made more widely available.

Whatever the future of the pill may be, Dennis believes he helped somebody in the trial.

"Having the knowledge that there's such a drug out there was real encouraging," said Dennis. "It's a very small part, but if I could do something to help this along I felt like I should."

http://abcnews.go.com/Health/AIDS/Story?id...2558&page=1
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01-22-2009, 06:35 AM, (This post was last modified: 01-22-2009, 06:38 AM by Hans Olo.)
#2
Trying a Pill to Prevent HIV
Condoms work really well, too. Btw, not a word in this article about how the drug works. Are we that stupid?
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01-22-2009, 09:56 AM,
#3
Trying a Pill to Prevent HIV
Quote:not a word in this article about how the drug works.

If you find anything out, post it up, Hans :)
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01-23-2009, 01:21 PM,
#4
Trying a Pill to Prevent HIV
there are other causes that bring the body down. Certainly it's not pills that can help there. One has to understand in what conditions the patient lived, and what possible conflict potential is there. Then, a solution is possible without expensive drugs.

One has always to remember that the term AIDS discribes not one single disease, it stands for a multiple choice of diseases, which could be triggered by something different. They collect these different diseases in the term "immune system deficiancy" or something like that. But there is also no immune system either, nobody ever made a proper definition of it. We have, like all organisms, a self-healing system. The body heals and balances out every day and night. If we get a cold and have some bacteria, they help to heal. They are not the cause of the cold, they repair it. The cause of the cold was a short moment where the person did not feel at ease. Then a biological program started to bring the organism into the best condition for healing, which can look like an illness at first glance. But with proper knowledge of what is going on in all organisms, we can recognize this fever as a healing process that also should be undisturbed.
Also it is important to repeat that some "anti-AIDS" drugs do have the same side-effects like the symptoms they put into the AIDS-drawer. So if you take this drug, you will have the side-effects, which the doctors interpret as AIDS-symptoms, and they will test another drug on you, for free experimentation. It is stupid what happens today in medicine, but cases like this are dramatically wrong. There is no AIDS, because there is no AIDS-virus. There are only diseases and complexes of diseases. All of them can be cured. And if you ever spot an image of a so-called HIV, it is not, it is just an ordinary bacteria or virus. It is not "the" AIDS-virus. They cheat. If they really bring a clear, scientifically convincing image of this HIV, then I will shut up. But I think almost 30 years should be sufficient to scientifically prove the existence of HIV. Obviously such a thing does not exist and will never be found.

Just as a starter, here is some more information:

http://www.wisdomofbeing.com/fivelaws.html


I am my savior
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01-25-2009, 01:36 PM,
#5
Trying a Pill to Prevent HIV
Apparently when you do the test they don't even test for the HIV, not even for antibodies against the virus, but for some enzymes that may or may not be associated with HIV and a dozen other conditions... and before the tell you their results you are asked all sorts of questions about your sexual habits.. I wonder if that has anything to do with the problem of false positives that occured. Also, in different states there are different standards for what is counted as a positive, so you can be tested HIV negative in one state and positive in another one.

In some of these documentaries that are around, the claim is made that HIV has never even been isolated in human blood. All we have seen so far is a couple of computer models, but not an actual HI virus. Is that true?
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01-25-2009, 02:45 PM, (This post was last modified: 01-25-2009, 03:08 PM by ---.)
#6
Trying a Pill to Prevent HIV
I don't know but for sure there is some manner of aggressive disease out there which is pernicious and targets the immune system. Potentially it is hard to isolate in tests due to the rapidity that it morphs at a cellular level - which also seemingly explains the deadly nature of it...

AZT et al may well be pharma corp spinning deathly lies at the end of the day but nevertheless, from wherever it came, be it from a lab or now traced to over a hundred years ago - maybe still from a lab - the disease we call HIV AIDS is still very much something which is reducing our species number by great number and is definitely not in and of itself a myth.

It's like ebola - you might'nt believe in the shit but it's nevertheless real. ebola - acute aids - closer to chronic ie not contained - but the more swift pandemic being set up is certainly more pressing, granted..

I hope some diligent human manages to make it to the public with the locked away antibody switches that all want known.
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01-26-2009, 09:46 AM,
#7
Trying a Pill to Prevent HIV
Another question: why hasn't HIV spread like hell? It doesn't, not in Europe, not on USA.
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01-26-2009, 09:51 AM, (This post was last modified: 01-26-2009, 09:52 AM by ---.)
#8
Trying a Pill to Prevent HIV
There certainly are disproportionately high rates in Sub Saharan Africa.
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01-26-2009, 09:12 PM, (This post was last modified: 01-26-2009, 09:14 PM by Phil999.)
#9
Trying a Pill to Prevent HIV
Quote:In some of these documentaries that are around, the claim is made that HIV has never even been isolated in human blood. All we have seen so far is a couple of computer models, but not an actual HI virus. Is that true?

Yes. If they could physically show this virus, this could change everything, and the AIDS danger could indeed be serious and real. And there are methods to display cells or bacteria, even single atoms. So it must be possible to scientifically prove the existence of HIV. Because this hasn't happened until today, it is more probable that AIDS is just a false theory.

The number of so-called AIDS-patients depends on what symptoms count as "AIDS". If you put many symptoms into that pot, you get a higher number as a result. Also it depends on the number of patients who get treated with anti-AIDS-drugs. Mass phenomenons are generally difficult to grasp, and this is true for AIDS numbers as well. The prophesized Catastrophy hasn't occurred, and I don't even thank God for that, because there wasn't any danger at all. There are health and nutrition problems in many countries in Africa and other parts of the world, bad water from industry etc., but an AIDS-epidemy cannot happen because it is just an intellectual construct of some chemists. Suffering does happen, but its cause are not viruses.

But I admit that the infection theory (which I believe is wrong in every case, not only AIDS) is much easier to grasp than the often hidden works inside our body and brain. The link in my last post is just a very brief summary of a system that describes those works very well.
I am my savior
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