Following news that America’s Food and Drug Administration (FDA) has approved a daily HIV “prevention” pill, South African HIV experts warned that this is no excuse to be irresponsible.

In the latest milestone in the 30-year battle against HIV, the FDA on Monday licensed the drug Truvada to be used daily for the prevention of HIV transmission by healthy HIV negative people who are at high risk of acquiring HIV through sexual activity, such as those who have HIV-infected partners.

While acknowledging that the news is a major breakthrough that significantly expands available HIV-preventive measures, Health4Men, the men who have sex with men (MSM) sexual health project in South Africa, issued a note of caution.

Glenn de Swardt of Health4Men said that the approval of Truvada does not imply that MSM should indulge in irresponsible sexual behaviour.

“We’re waving a red flag, reminding men that Truvada does not in any way provide an excuse for barebacking (having unprotected sex),” commented de Swardt. “The basics haven’t changed; always use condoms and compatible lubricant for anal sex.”

Executive director of the Anova Health Institute Prof James McIntyre added that Truvada merely augments but does not replace other available strategies for preventing HIV infection.

“The strength of this development lies in the fact that it adds another layer of protection by turbo-charging existing strategies such as consistent condom use and reducing your number of sexual partners.

“Using Truvada for prevention can never be a stand-alone; it is essential that it be used in conjunction with other prevention methods to form a reliable combination of strategies that reinforce each other,” he said.

Health4Men also noted that Truvada is not yet registered for HIV prevention purposes in South Africa. De Swardt explained that while the Health Department has not yet included Truvada for prevention in their health programs and it is therefore not freely available, the drug can already be used with discretion by experienced physicians in selected situations if patients can afford paying for it themselves.

“Health4Men has already scripted Truvada for prevention purposes at our Ivan Toms Centre for Men’s Health in Cape Town, a public service clinic run in partnership between Anova Health Institute and the Department of Health,” De Swardt said.

Since 2010, studies have shown that daily doses of the drug reduce the risk of infection in healthy HIV negative people by between 42% and 75%.

Health4Men currently operates seven clinics dedicated to MSM, offering comprehensive free healthcare services including ARV treatment. The organisation has been actively involved in the development of guidelines for the safe use of Truvada among MSM in South Africa. For more information on Truvada and its use, contact the organisation.

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