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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Using AIDS Drugs to Prevent Infection: A Bargain?
Julie Steenhuysen
April 18, 2012
Reuters (04.17.12) - Wednesday, April 18, 2012

In a new study, researchers at Stanford University found that using AIDS drugs to prevent infection among men who have sex with men (MSM) and are at high risk of HIV infection would be expensive, but could also reduce infection rates significantly.

The authors estimate that if 20 percent of high-risk individuals - MSM who have five or more sexual partners a year - took the drug Truvada as a form of pre-exposure prophylaxis (PrEP), it could prevent 41,000 new infections over 20 years. The cost would be about $16.6 billion.

In contrast, the team estimated that giving the drug daily to all MSM in the United States would cost $495 billion over the same 20-year period, including the cost of drugs and health care visits. In addition, giving the drug for PrEP might limit its use for treating people who are already HIV-positive.

"Use in high-risk [MSM] would provide substantial health benefits at a lower cost, although the budgetary effect would still be sizeable," said Jessie Juusola, one of the Stanford researchers.

Since 2010, when a landmark study in the New England Journal of Medicine found that that giving a daily dose of Gilead Sciences' Truvada to MSM can reduce HIV infection rates by 44 percent, efforts have been made to find a way to make PrEP financially feasible.

A Food and Drug Administration advisory panel is expected to consider in mid-May whether to allow Gilead to market the drug as a way to prevent HIV infection in healthy people. The drug already is approved to treat people who are infected with HIV.

The new study, "The Cost-Effectiveness of Preexposure Prophylaxis for HIV Prevention in the United States in Men Who Have Sex with Men," was published in the Annals of Internal Medicine (2012;156(8):541-550).