The HIV Morning After Pill?

Those plugged into the gay party scene are already familiar with an alphabet of one-letter party drugs—E, K, X. Now meet the latest drug to join the alphabet soup of party drugs: T, short for tenofovir, the potent anti-retroviral drug marketed by Gilead Sciences under the trade name Viread used to fight HIV/AIDS. (First mentioned here in March 2006.) Experts say more HIV-negative gay men are taking a single dose of tenofovir before a weekend of partying and unprotected sex, hoping that it will protect them against the virus.

Preliminary evidence shows this is possible because tenofovir is used in HIV-post exposure prophylaxis, sort of a "morning after pill", but, usually in a three-drug regimen taken for a month after exposure. However, the prescription medication can be easily found in many gay clubs or through friendly local street pharmacists, usually sold in a "party pack" that includes crystal meth and Viagra—a trail mix that encourages unprotected sex.

Tenofovir's availability may or may not promote irresponsible behavior—but not everyone follows traditional prevention formulas. In the January edition of Out, Dr. Tony Mills—the West Hollywood HIV specialist—says he is beginning to prescribe T for HIV-negative patients who refuse to use condoms and/or are in a sexual relationship with a poz partner.

"What I'm seeing lately is that many of my patients are having more risky sex, whether it's due to condom fatigue or the use of crystal meth," Dr. Mills explains. "Or that they have a partner who is positive, or for a lot of other reasons. So I have to be willing to consider this as a harm-reduction strategy for them."

More Crystal, Viagra and HIV:

New Public Awareness Campaign (Rod 2.0) Mixed Messages in Chelsea (Towleroad) Suicide Tuesdays (Rod 2.0) Tina, Ann and Nick (Rod 2.0) (Virtual) Sex and the City (Rod 2.0) The New Face of Crystal Meth (Rod 2.0) Crystal Meth-Related Emergency (Rod 2.0)

Comments

[carl]

I've never, ever heard of thsi drug or that there even was an HIV morning after pill. Wow. Thanks.

[jared]

this is really strange to say the least. the same ones who are doing high risk behaviour, think that taking a pill before whooping it up is going to "save" them? funny, i had not heard that there was a cure for hiv, other than common sense. condom fatigue? give me a break, only a fool would have this issue. my only fatigue is that these men and women won't take the time to adopt safer sex attitudes and only do it because it feels good and no worries about what can happen and all the lives involved.

[ChippyG]

Thanks for the info, Rod. News of this drug has been slow to reach those who might benefit from it. Or perhaps it has been inadequately promoted. Hmmm... But saying that Tenofovir promotes irresponsible behavior is like saying aspirin encourages banging ones head on the wall. This drug offers a new front in the battle against HIV. That some of us, whether through addiction, self hatred (redundant?) or just plain ignorance, choose to use the drug to facilitate their games of Russian roulette does not diminish the potential of this medication to save lives.

[C. Baptiste-Williams]

if this is usually a part of a 3 pill regimen... is there any proof it works alone??

[Joy]

This is just another reason for someone to make money of the irresponsibility of others. Just like diet drugs. Those with weight problems hang their hopes on a magic pill to solve all their problems when their problem is diet and exercise. The smart ones will stay away from this. The others will hopefully learn the hard way. Either way its still a shame (shakin my head)

[jeff]

I believe tenofovir is the drug a friend of mine had been taking for HIV. It led to Kidney failure.

[Matt Florence]

Hi Rod, thanks for posting this information. I work with the San Francisco Department of Public Health's HIV Research Section. In fact, we're doing a study of tenofovir as a prophylactic against HIV infection. Right now, we're simply studying the safety of taking the pill once a day.

There is some evidence that it is medically safe for HIV negative people. But one of the biggest questions, which you highlight, is whether having this medication available will change peoples' risk-taking patterns. That's a big question. More importantly, trials are underway (and others are being developed) to determine whether this medication will actually be effective in keeping someone from becoming HIV infected. We don't know. And that's probably the biggest concerns that researchers have right now. We just don't know if this is going to work. Everyone should be advised that this is an unproven strategy, and that taking Tenofovir is not proven to counteract against HIV infection. We're continuing to recruit people into a study about this drug in both San Francisco (www.helpfighthiv.org) and Boston (www.fenwayhealth.org). People who are interested in helping us answer these questions should contact us to become part of a clinical trial. But, again, I just want to say that people should not start using tenofovir as if it were a proven strategy.

[Rod McCullom]

Jeff is right. Tenofovir has been associated with liver and kidney failure. These are important factors to consider before taking the drug, given your own immune history. Viread can be even more problematic for HIV-positive people who have a history of kidney problems. That information was provided in the links but, I'm glad that it came up in the comments thread.

Also, please follow the expert advice given by Matt Florence: You should not start using tenofovir without a prescription and as if it were a proven strategy.

RM

[Greg G]

It doesn't seem that tenofovir promotes irresponsible behavior. Despite warnings, many men are still having unprotected sex. It is what it is. And, the drug's possible new promise is another front in the war on AIDS.

Off topic, thanks for postings this Rod. This is the only place where in five minutes I can learn the latest breakthroughs on HIV, a Diana Ross tell-all and the latest from Washington. You go, boy.

[Jim Maynard]

I want to thank Matthew from SF for his comments. I am working on the same research project at the Boston site and, as exciting the possility of having a new tool in the fight against HIV infection may be, I want to also warn against using a drug that has not been proven to work, and to do that with someone else's prescription drugs. If you have a friend who is taking Tenofovir as a party drug, have a talk with them. Remind them that condoms are still the only proven method to keep yourself safe! Contact one of our 3 sites (see Matthew's posting) if you want to look into being in a controlled safety study.

[Dan]

Has there been any proof that taking the pill works? Also, there is only mention of Viread. Does the same hold true for Truvada--combiniation of Viread and Emtriva?