AEGiS-WSJ: U.S. Backs Limited Use Of Emergency HIV Regimen

Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.

U.S. Backs Limited Use Of Emergency HIV Regimen

Wall Street Journal - January 20, 2005
Betsy McKay at betsy.mckay@wsj.com

ATLANTA -- The U.S. government, in a long-awaited move, recommended that people exposed to the AIDS virus through rape, occasional unsafe sex and rare accidents be offered emergency drug treatment to prevent infection, but warned that the medication shouldn't be viewed as a "morning-after pill" for HIV.

The guidelines, developed by the Centers for Disease Control and Prevention and other federal officials, expand a 1996 recommendation for health-care workers.

CDC officials said yesterday the treatment -- a combination of three antiretroviral drugs that must be started within 72 hours of exposure and taken for 28 days -- may be offered to people who suffered a rare exposure to the virus. They cautioned that the treatment shouldn't be prescribed repeatedly.

"This is a complex regiment and not a substitute for abstinence, mutual monogamy, consistent condom use and use of sterile needles," said Ron Valdiserri, deputy director of CDC's National Center for HIV , STD, and TB Prevention. "It is clearly not a morning-after pill." The "morning-after pill" is emergency birth control to reduce the risk of pregnancy, if taken within 72 hours of unprotected sex.

The anti-HIV drug regimen, known as "post-exposure prophylaxis," is considered an important but last-resort tool for preventing the spread of the AIDS virus. It is widely used in Europe, Australia and Brazil, particularly to prevent infection in rape victims. Massachusetts, New York and Rhode Island have developed similar recommendations since 2000; California guidelines await final approval from Gov. Arnold Schwarzenegger.

If taken properly, the drugs can prevent infection by keeping the HIV virus from spreading beyond a few exposed cells. But they don't always work, the CDC cautions. The treatment also has side effects, including nausea and fatigue. Dr. Valdiserri said treatment should be combined with counseling. Patients who put themselves frequently at risk of HIV infection shouldn't be turned away, but referred for more counseling and drug treatment.

The practical effect of the endorsement is that the treatment will become more widely available. Whether many who need it will be able to afford it is unclear; there is no federal funding to pay for the program. Some large insurers have paid for treatments offered at Howard Brown Health Center in Chicago, Ill., according to Mark Hodar, the clinic's HIV/STD services manager. But many patients don't file for the benefit because they don't want their insurance company to know they engaged in risky behavior, Mr. Hodar said.

AIDS experts said the government's move was welcome but overdue. "They're rather late to the game," Mr. Hodar said, but he added that the government's support "will really open this up to a population that hasn't had it before."

050120
WJ050105

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Elton John AIDS Foundation UK, the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .