HIV preventative treatment safe for teens
An HIV-prevention pill‚ taken once-a-day‚ is safe for teenagers to use‚ according to a South African study released at the International Aids Society conference on Tuesday.
South Africa has the largest number of people living with HIV in the world and teenage girls are at highest risk of contracting the disease.
But for now the HIV prevention pill‚ Truvada‚ is only licensed for adult preventative use.
Truvada can reduce the risk of contracting HIV by at least 90% if taken daily.
There is some discussion by the Department of Health and the Department of Education that the preventative pill Truvada possibly be given to high risk teens in the future and the drug Truvada is mentioned in the Department of Education's latest policy on sexual health in schools.
A small South African trial tested the HIV pill in teens aged 15 to 19 in Johannesburg and Cape Town. The study included 99 girls and 49 boys.
In total‚ 57% of the teens took the pill for the first three months.
Of the 87% participants who remained using the pill‚ only 38% took it for another 3 months.
Only one person‚ a 19-year-old‚ contracted HIV in the trial three months after she chose to stop using the drug.
The trial showed it was safe for teenagers to use to use with minimal side effects.
"Adolescents and young people represent a growing share of people living with HIV worldwide‚” noted Anthony Fauci‚ director of the National Institute of Allergy and Infectious Diseases ‚ part of the National Institutes of Health who funded the study.
“Science has demonstrated that the HIV prevention needs of adolescents may be different than those of adults‚ which is why these new study findings are so important.”
Asked about the fact only 38 % of the teens took the drug for six months‚ Fauci told TimesLIVE it can be difficult to get people to take medication when they are healthy and do not have a disease.
At first teens had monthly meetings to encourage meetings‚ but as they had fewer support meetings‚ they took the drug less.
“The trend toward lower adherence to Truvada for PrEP as study visits became less frequent parallels what was observed in a study of PrEP in adolescent gay and bisexual boys‚ suggesting that monthly study visits may support greater adherence to oral PrEP among adolescents over time‚” said one of the researchers‚ Professor Linda-Gail Bekker‚ director of the Desmond Tutu HIV Centre at the University of Cape Town.
The study is part of evidence that can be used by doctors and health department experts to draw on guidelines on how to implement Truvada guidelines‚ according to the media release.
University of KwaZulu-Natal pharmacist Andy Gray said in order to offer effective HIV prevention‚ many options needed to be available.
"The challenge is finding the unique mix of interventions that suits every high-risk person – from the menu of PrEP [a pill a day]‚ condoms‚ monogamous relationships‚ avoidance of other risk behaviour (like IV drug use or binge drinking). No single intervention will be 100% effective‚ and 100% acceptable to every individual."
Gray said adherence to medicine even for long term illnesses was usually low.
Gray explained that for example‚ only half of people with high blood pressure control it well‚ with almost half of users not taking their pill every day.
He said: “Teenage type 1 diabetes are very difficult to manage as they are known to dislike injections.”
He said asthmatics skip taking "inhaled steroid doses‚ even though they know that puts them at risk of an acute attack".
Researchers are searching for as many prevention options as possible for HIV.
A new trial comparing a vaginal ring which secretes an ARV drug into women with the preventative pill is starting soon in South Africa. It aims to see which options teenagers prefer.