Should all sexually active gay men be taking HIV preventative medication?

The World Health Organisation’s specialist unit for HIV has recommended that all sexually active gay men should consider taking antiretroviral medicines as a tool to combat the spread of HIV alongside other safe sex measures.

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Taking pre-exposure prophylaxis medication, for instance as a single daily pill combining two antiretrovirals, in addition to using condoms, has been estimated to cut HIV incidence among such men by 20-25 per cent, WHO said, stressing that this could avert “up to one million new infections among this group over 10 years”.

Taking pre-exposure prophylaxis medication, for instance as a single daily pill combining two antiretrovirals, in addition to using condoms, has been estimated to cut HIV incidence among such men by 20-25 per cent, WHO said, stressing that this could avert “up to one million new infections among this group over 10 years”.

The recommendation comes as HIV transmissions amongst men who have sex with other men reach their highest level in a decade.Gottfried Hirnschall, who heads the World Health Organisation’s unit described the current situation as “exploding epidemics”. The organisations says that worldwide men who engage in sex with other men are 19 times more likely to be exposed to HIV than if they didn’t have sex. A widespread role out of the  Pre Exposure Prophylaxis (PrEP) treatment could see as many as one million people avoid gaining the virus over the next ten years.

The WHO is not advocating PrEP treatment as a substitute for existing strategies like condom use, rather the use of medication is suggested as an additional tool to combat the virus. A similar suggestion was put forward by the United States Centre for Disease Control in May. At the time Michael Weinstein, president of the AIDS Healthcare Foundation raised concern that the move could backfire leading to riskier behaviour if the medication was seen as a substitute to condoms.

Gottfried Hirnschall agrees, saying that the treatment should be just one more thing being utilised to reduce the spread of the virus.

“Given the situation, we clearly need to have an arsenal of interventions, together with many others: and that’s condoms; lubricants; testing obviously is important; adherence counselling.

“So we don’t say this is the single silver bullet that everybody will use, but we know that this is the right thing for some people to use.” Hirnschall said.

Hirnschall also highlighted that whether an individual decides to take the drugs who be based on their own personal situation.

“If you live in a stable relationship or a serocordant relationship with both partners HIV negative and you have no risk, you have absolutely no reason to take” the drugs, Hirnschall said.

“If it’s a serodiscordant relationship, where one is (HIV)-positive and the other is (HIV-)negative, this might be an option that the (HIV-)negative partner considers.”

A study is currently being run in Victoria to access the effectiveness of the medication as a preventative tool.

OIP Staff

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