By Kevin M. Gibas
In June of 1981 the Centers for Disease Control detected a cluster of rare infections in a group of gay men in California.
Although unknown at the time, this would mark the beginning of the AIDS epidemic that would plague the United States for decades. By 1983, it was discovered that AIDS was a syndrome caused by the human immunodeficiency virus (HIV), which would leave a person’s immune system weak and unable to fight infections.
Over the next four years, more than 16,000 people in the United States died of AIDS, and hope for a treatment was bleak.
However, in 1987 there was a breakthrough when the first medication to treat HIV was approved. Therapies advanced throughout the 1990s and 2000s and effective treatments consisting of multiple drugs were developed.
Thanks to the advent of these anti-HIV medications, the situation has changed since the 1980s and 1990s; however, the number of HIV infections in the United States has continued to increase.
The trends of the last two decades have shown that even though we are certainly getting more effective at treating HIV, we may not be getting better at preventing it.
This was recognized as an important public health issue, and in 2012 the FDA approved the first drug, Truvada, for pre-exposure prophylaxis (PrEP), meaning to prevent HIV infection. Truvada is one pill that combines two anti-HIV medications. Studies show that daily Truvada or PrEP use can lower the risk of contracting HIV from sexual activity by more than 90 percent.
However, for many Americans who may benefit from this drug this just may be too good to be true – Truvada comes with a hefty price tag of up to $1,500 per month without insurance or other assistance program.
This is likely the main reason that even though Truvada was approved for the prevention of HIV infection more than five years ago, less than 10 percent of the people who may benefit from it are taking it.
On June 9, however, the FDA approved the first generic version of Truvada. Although we do not yet know what the cost of generic Truvada will be, this announcement is giving many people hope that there will soon be greater access to the disease-preventing drug.
Regardless of the cost of the generic version of Truvada, it is the responsibility of health care professionals, government organizations and community leaders to ensure that all people who may benefit from this life-saving medication have safe and affordable access to it.
Although the HIV/AIDS epidemic does not often make the front page of the paper or make the evening news in the ways that it did in the 1980s and 1990s, it does not mean the fight against HIV/AIDS is over.
Kevin M. Gibas, M.D., formerly of Buffalo, is a resident in internal medicine at Harvard Medical School’s Beth Israel Deaconess Medical Center in Boston, Mass..