Jan 222009
 
Authors: Matthew Peterson Louisiana State University

(U-WIRE) – There’s a new and incredibly dangerous fad in certain sectors of the gay community these days. Called “pre-exposure prophylaxis,” or PrEP, it’s the worst trend in sexual health since the Coca-Cola douche.

Rather than use condoms to prevent HIV transmission, men engaging in PrEP take a single dose of an illicitly obtained anti-HIV drug before having unprotected sex.

The idea is similar to post-exposure prophylaxis, which is a well-studied method of preventing transmission of a pathogen after accidental contact. Patients are prescribed the full cocktail of AIDS medications and must take them for four full weeks, according to United States Public Health Service guidelines.

Studies of post-exposure drug treatment confirm its effectiveness, particularly when therapy is started immediately. But concluding from this that a single pre-emptive treatment offers protection from AIDS is a Bush-level misunderestimation of HIV transmission.

Most immediately, there’s no data to support the idea that PrEP actually works. Preliminary animal trials have shown interesting results, but human testing has been derailed for political and ethical reasons.

It might seem logical that some kind of pre-emptive treatment could prevent infection, but fundamental questions about the practice have yet to be answered.

How long should patients take the preventive? Is a single dose of a single drug sufficient? Could a sufficiently large viral exposure overwhelm any drug treatment?

At this point, no doctor can do better than guess at these answers.

And there are worse possibilities than PrEP simply failing.

Consider antibiotic-resistant bacteria. Antibacterial agents are now used so frequently that “superbugs” – bacteria unaffected by the most common antibiotics – have evolved. In many cases, patients infected by drug-resistant strains die for lack of any effective treatment.

Just as the overuse of antibiotics has caused the evolution of superbugs, so might the misuse of AIDS drugs in PrEP lead to an HIV strain able to shrug off today’s antivirals. Calling this a public health nightmare would be gross understatement.

Speaking of public health nightmares, HIV is not the only sexually transmitted infection out there. A recent report from the Centers for Disease Control and Prevention offers some sobering statistics.

Health authorities reported more than 1.1 million chlamydia infections – the highest number recorded in a single year – to the CDC in 2007. The number of syphilis cases among men has increased by 64 percent since 2003.

Thinking PrEP protects against other infections is an even bigger flight of fancy than assuming it guards against HIV.

Despite these dire statistics, a marvelous device exists which offers a remarkable level of protection against all STIs.

Consistent and proper use can decrease the risk of HIV infection by 85 percent, lower the risk of gonorrhea transmission in men by 71 percent and reduce chlamydia transmission by 33 percent, according to the National Institutes of Health.

This wondrous invention even prevents pregnancy!

It’s called a condom.

If a drug with the same properties were developed, it would become the world’s best-selling medication overnight.

The desire to take a pill to solve life’s problems is understandably alluring, but one cannot wish away the obligation to treat oneself and one’s partners responsibly.

Sex is undeniably messy and complicated. Ironically, the best way to solve its myriad problems is to wrap them up in a neat latex package and throw it away at the end of the night.

Let’s see a magic pill do that.

 Posted by at 5:00 pm

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