In a breakthrough in the fight against a disease that has been a specter for a generation, a mediation has recently been endorsed as a pre-exposure prophylaxis for HIV, after gaining FDA approval two years ago. That means that, for people at high risk of contracting HIV, the virus that causes AIDS, this pill, taken on schedule, can substantially improve their chances of not acquiring the virus. For HIV-negative people in serodiscordant relationships—couples in which one partner has the virus and the other does not—this could mean big changes in intimacy in the relationship. While transmission in such interactions can be reduced, by barrier protection and by the HIV-positive partner taking steps, such as anti-retroviral treatment, to reduce viral load to undetectable levels, the prophylactic medication can give these protections a significant boost in effectiveness.
No generally effective cure for AIDS has yet been found, but anti-retroviral treatments can slow the progress of the virus and prevent people who have been infected from developing AIDS if they haven’t, and can help restore immune response in people who have developed AIDS. Over time, these drugs can reduce viral load—the amount of HIV in the body—to blow the level at which it is actively causing harm or likely to be transmitted. However, the virus is still present, and if the treatment is stopped it can re-emerge and grow.
Truvada, the prophylactic drug, is a brand name for a combination of the anti-retroviral drugs tenofovir and emtricitabine that has been used to treat HIV infection for a decade. In 2012 it was realized that the combination also has a preventative effect when taken by HIV-negative people. It lowers the risk of contracting the virus from a partner known to be HIV-positive by 42 percent. People taking the combination for prevention are urged to get tested four times a year, and are encouraged to continue any preventative measures thy are already using. One benefit of the preventative treatment is that it is a way of giving some measure of control to the HIV-negative partner. Rather than relying on the HIV-positive person to be vigilant about their partner’s safety, it gives the person assuming the risk a tool to help manage that risk.