The U.S. Food and Drug Administration have approved an ART to prevent HIV-negative people from being infected with the virus. The idea is that so-called high-risk people can take it.
Overall, I think this is a great idea, but I’m a little concerned over who will be able to access it and who will not.
For example, I think discordant couples are a great place for Truvada to be used in a prevention setting. The person who is HIV negative can have just one layer of extra protection. I also think it is a great idea for commercial sex workers, especially those for who may find themselves in a position where they cannot demand condom use.
But I have a concern for the Saskatchewan setting (should it ever be approved in Canada) and it’s high-risk drug using population. My concern is this, when it comes to injection drug users, who are actively using and thus at risk, will they be able to take the medication as regularly as required? This ART, like antibiotic, taken incorrectly could create a resistant strain of HIV. To have Truvada work, there would need to be very efficient outreach systems in place, where IDU (intravenous drug users) would have the support they need. It’s more than just the medication they require, but housing, nutrition and addictions support. It would need to be daily. I don’t see those systems in place now. There are some, but it’s not enough.
So, while I think it is fantastic that Truvada has been approved in the United States, there needs to be a lot more work before an ART could be used effectively in Saskatchewan.