Dummies guide to Truvada

16 March 2016 - 12:01 By Katharine Child

HIV-negative sex workers are getting it for free‚ gay men in San Fransisco love it and a drug company is urging medical aids to pay for it. Do you need it? Read this dummies guide to find out:Truvada was licensed by the Medicines Control Council (MCC) for use in November. Taken daily‚ this pill‚ which contains two antiretorvirals‚ has above 90% chance of preventing HIV.Drive to cut price of HIV-prevention drugsBut it costs R550 in the private sector and it has to be taken every day. Medical aids have indicated that they will pay for it for people who qualify for the drug.So who qualifies for Truvada? Every medicine has a risk - or side-effect - but people will be advised to take any medicine if the benefit of the drug outweighs the risk.In the case of cancer‚ the risks of chemotherapy is outweighed by the benefits of beating the disease. As the people taking Truvada are not sick‚ the benefit has to outweigh the risk of taking a medicine while healthy.People at significant risk of HIV benefit and studies have shown they are more likely to take it if they believe they could catch HIV.Promiscuous gay and bisexual men have used it in America‚ France and Britain with great success.The SA HIV Clinicians Society’s Francesca Conradie said young women in South Africa may also fall into this high-risk category as they have highest rate of HIV in the couuntry. A discussion about it could be had between doctors and patients when discussing contraception‚ she suggested.Can we afford it? It's cheaper than getting HIV. People who take Truvada take it for a few months or years while engaging in risky sexual behaviour. They seldom need it for their whole lives.However‚ once positive‚ a patient needs ARV treatments for life.Aspen Pharma this week indicated it was dropping the price of Truvada from R550 to R480 to make it more affordable.Head of Metropolitan’s HIV Division Siraaj Adams said perhaps "advocacy" was needed to drive the price down further to make it cheaper for medical aids to pay for high risk clients to take it.What not to do:In large-scale trials of thousands of local women‚ a similar preventative pill didn’t work because the women didn’t take it.Researchers realised that people who are not sick will only take a daily drug if they perceive themselves to be at risk of disease.Intensive research has shown a person has to believe they are at high risk of contracting HIV to motivate regular and correct use of the drug.If they don’t believe they are at a high risk of getting HIV‚ even if they are‚ they are unlikely to use the drug.Who cannot take Truvada: If you are HIV-positive‚ you cannot take the drug as it will not treat HIV and you will develop resistance to the drug.Truvada users have to be negative and have blood tests every three months to ensure they remain negative.If a user of Truvada tests positive‚ they have to be switched to different drugs that contains three ARVs. Truvada is made of two ARVs and can only be used as prevention.A test to determine healthy kidney function is conducted every three months to ensure Truvada is not damaging the user's kidneys.A patient with kidney damage would not qualify to use the drug.What doctors need to do: The SA HIV Clinicians Society is training doctors on who to prescribe it to and how to do so."This requires taking a detailed sexual history to find out of the person is engaging in risky behaviour‚" said president of the SA HIV Clinicians Society‚ Francesca Conradie."Some doctors are squeamish about this‚" said Conradie but it is necessary.Can a person stop taking it? A person who enters a stable relationship‚ and who is no longer at risk of HIV‚ may choose to stop taking it.They need 28 days after their last risky encounter before stopping it.It takes 20 days for a woman and seven days for a man for Truvada to enter the body’s tissues in sufficient quantities to start working. – TMG Digital/The Times..

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