Man Tests Positive for HIV Despite Taking PrEP Every Day

A gay man has been infected with HIV despite taking Truvada every day for 2 years.

The case, which was reported by a scientist at the recent Conference on Retroviruses and Opportunistic Infections in Boston, is the first reported failure for pre-exposure prophylaxis (PrEP).

Truvada has been touted by both the US Centers for Disease Control and Prevention (CDC) and the World Health Organization as a highly reliable medication to lower the risk of HIV infection when taken consistently among those at high risk for transmission.

In the current case, pharmacy records and dried blood spot analysis both indicated “consistent dose-taking in the preceding 1 to 2 months,” noted David Knox, MD, an HIV specialist and lead author of the new study, during his presentation. The patient was reportedly “adamant” that he was completely adherent to PrEP since he first began the regimen in August 2013.

Dr. Knox also explained that the patient’s HIV-positive partner had “undetectable” levels of antiretroviral therapy, and he reported having anal sex without a condom within 2 to 6 weeks of testing positive for the infection.

“Failure of PrEP in this case was likely due to the transmission of a PrEP-resistant, multiclass resistant strain of HIV-1,” the study authors concluded.

A survey conducted by the American Academy of HIV Medicine already revealed several barriers that prevent many health care providers from prescribing PrEP to patients at high-risk for HIV, and this study’s findings may fuel more controversy about PrEP prescribing.

Some Truvada critics have said that the pill encourages riskier sexual behavior without condoms. AIDS Healthcare Foundation President Michael Weinstein previously referred to Truvada as a “party drug.”

As medication experts, pharmacists know how to counsel patients thoroughly about the clinical benefits, risks, and adverse side effects of PrEP. They should also remind patients that although PrEP is not perfect, it could reduce their risk of HIV by 92% when taken correctly and consistency.

“Pharmacists can be first-line providers in providing information…and can play a role at each stage of the HIV [prevention] and care continuum,” Jacek Skarbinski, MD, of the CDC previously told Pharmacy Times.