The Future of Medicine: The HIV Prevention Pill

https://i0.wp.com/cdn3.vox-cdn.com/uploads/chorus_image/image/35164636/Andrew_Cuomo_2013__2_.0_standard_640.0.jpgEarlier this month, New York State governor Andrew Cuomo did something very meaningful and unexpected. In an effort to drastically cut the rate of new infections in the state, he announced that he was backing the development of Truvada – the controversial HIV prevention pill. The pill was officially endorsed by the CDC in May, but this is the first time that a high-level elected official has recommended its use.

Currently, about 3,000 new HIV infections are reported in New York state each year. Cuomo wants to reduce that to 750 by 2020, and to do so, he has introduced a three-pronged strategy. Parts one and two focus on more HIV tests and getting more people with HIV to see physicians. But the third part, which includes making Truvada readily available, has the potential to cause a stir since some believe that an HIV-prevention pill promotes lower rates of condom use.

truvada_0Luckily, a recent scientific study conducted by the University of California at San Fransisco found no link between use of the drug and condom use. More importantly, the drug has a proven track record when it comes to preventing HIV. Recent reports state that it cuts infection rates by more than 90 percent, and people who take the drug every day are 99 percent protected from the onset of infection.

Furthermore, despite its $13,000-a-year price tag, the drug is covered by most insurers. So, its continued obscurity appears to have more to do with marketing than anything else. In truth, many people who are at risk for HIV still aren’t aware of the drug’s existence. And despite the CDC’s recent backing, its manufacturer, Gilead, has yet to market the drug for HIV prevention, even though it is currently used as part of treatment regimens.

http://cbsnewyork.files.wordpress.com/2014/03/479278263_10.jpg?w=620&h=349&crop=1This is why Cuomo’s announcement, which took place during Pride Weekend, was so important. By backing the drug formally, and encouraging physicians to get the word out, he is helping to promote awareness and curb HIV infection rates. Naturally, there are those who think Cuomo’s announcement is part of a ploy to get votes from members of the LGBTQ community.

Given the recent decline in condom use among teens of all sexual orientations, this is certainly good news. While a drug like this does nothing to prevent the acquisition of other STIs – such as gonorrhea or chlamydia – it is important to remember that these diseases are treatable and non-fatal. Ultimately, having an HIV prevention drug available will ensure that there is a preventive measure in place that people are more likely to use.

HIV-budding-ColorBeside the Truvada endorsement, the state is also set to start enforcing a 2010 law that requires doctors to regularly offer HIV testing to patients between the ages of 13 and 65. And the state recently repealed a law that asked doctors and nurses to obtain written consent from patients before performing HIV tests, because the requirement acted as a barrier to testing.

As a recent article in The New York Times points out, the most notable aspect of the state’s rejuvenated approach to combating HIV is the combined economics of the strategies involved. None of these methods should lead to increased spending because they don’t include new medical breakthroughs. Instead, the state will probably end up saving money since every prevented HIV case saves about $400,000 in medical costs.

https://i2.wp.com/media.sacbee.com/static/weblogs/photos/images/2011/jun11/gay_pride_ny_sm/gay_pride_ny_09.jpgAnd this is just one of many HIV preventions that has been proven safe, effective, and ready to market. Between bee-venom nanoparticle treatments, vaccines, and even topical creams that have been proven to eliminate the virus, the coming decades are likely to see a severe drop in the number of deaths associated with the disease. And by mid century, who knows? The disease that became the plague of the 20th century may finally be history!

Source: theverge.com, nytimes.com

The Future is Here: The HIV-Preventing, Contraceptive-Delivering, Dissolving Condom

condomDoesn’t that sound like a tall order? A nanofabricated condom that delivers an anti-HIV drug, prevents pregnancy, then disappears so as not to create waste. Did I say tall order, or something out of a dream? Hard to say. The point is, its could soon be reality thanks to researchers at the University of Washington who just published a paper in describing how they’ll use “electrospinning” to create next-generation female condoms made from specially customized nano-fibers.

For those unfamiliar with the terminology, electrospinning is a process where an electrical charge is used to draw very fine fibers (typically on the micro or nano scale) from a liquid. Using this method, the UofW researchers hope to weave an ultra-thin series of cloth-like fibers and medicine together to create female condoms that will boast all the necessary protection and contraceptives to make recreational sex perfectly safe. And the rate of disolution, which can be engineered to take place in a matter of minutes, hours or days, ensures that women don’t need to remove it after sex is had.

According to their abstract, the new condom is based in the field of “Multipurpose prevention technologies (MPTs)”, a relatively new concept that seeks to “simultaneously prevent sexually transmitted infections (STIs) and unintended pregnancy”. Given the current rate of population growth and the ongoing epidemic of HIV/AIDS and other STI’s, this new field is considered to be a possible answer to a growing global health concern. What’s more, they claim that “combining chemical and physical barriers offers the greatest potential to design effective MPTs, but integrating both functional modalities into a single device has been challenging.”

The abstract also goes on to describe the process that they will be relying on and the results:

“Using FDA-approved polymers, we fabricated nanofiber meshes with tunable fiber size and controlled degradation kinetics that facilitate simultaneous release of multiple agents against HIV-1, HSV-2, and sperm. We observed that drug-loaded meshes inhibited HIV-1 infection in vitro and physically obstructed sperm penetration. Furthermore, we report on a previously unknown activity of glycerol monolaurate (GML) to potently inhibit sperm motility and viability.”

Despite the challenges in the process, the results thus far have been encouraging, and even garnered the attention of Bill and Melinda Gates. Apparently, their Foundation has pledged a research grant of one million dollars to develop the technology which will make these condoms possible. I don’t know about you, but I feel safer!

Source: IO9.com