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Guidelines for HIV meds that stave off infections released by CDC

The Centers for Disease Control and Prevention in Atlanta issued new guidelines last week designed to help health care providers counsel patients and determine if taking powerful antiretroviral medications will be an effective prevention strategy.

The new guidelines come just months after a major study found that daily use of tenofovir plus emtricitabine, called Truvada, reduced the potential of infection for high risk men who have sex with men by 44 percent. The use of the medications in this type of treatment is called pre-exposure prophylaxis PrEP. That study also found that men in the program reported fewer sex partners and increased use of condoms.

The Bay Area Reporter in San Francisco reports the new guidelines are applicable only to men who have sex with men.

The CDC guidelines show that the medications should only be used on persons who are HIV-negative but are confirmed to be at “substantial, on-going high risk for acquiring HIV infection.” Under the guidance doctors are directed to screen the patients for HIV as well other sexually transmitted infections.

The problem with this prevention method is the cost of the medications, not to mention the on-going costs of monitoring how those powerful medications are impacting the body. The cost of Truvada is about $10,000 a year. The patient also has to have regular blood draws to monitor body functions like liver and kidney functions as the medications can cause damage to both organs.

Most HIV-positive people in Michigan are on Medicaid, which foots the bills for blood tests and medications. Some infected Michigan residents do not qualify for Medicaid, but receive HIV related medications through the AIDS Drug Assistance Program. ADAP is funded with federal dollars and drug company rebates, but many states have found that increased focus on testing as well as a change in formal recommendations as to when to start using the medications have resulted in swollen ADAP program enrollments. The change was made in 2009, and recommended an earlier start to the medications.

As a result, the ADAP programs are overwhelmed on a national level. Florida has the largest number of HIV-positive people awaiting access to that state’s ADAP program, and on Tuesday, the approximately 6,500 people enrolled in the program lost access. The reason? The program ran out of money and won’t get a new revenue stream for two months, reports our sister site The Florida Independent.

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