U.S. Urges Wider Use of Preventive HIV Drug Therapy

Potential recipients include victims of sexual assault

Randy Dotinga

Randy Dotinga

Updated on January 21, 2005

THURSDAY, Jan. 20, 2005 (HealthDayNews) -- In a nod to a controversial approach to AIDS prevention, the U.S. government is recommending that a potentially lifesaving HIV therapy be used by a broader group of people, including victims of sexual assault and those exposed to the AIDS virus through occasional unsafe sex or drug use.

The treatment, known as post-exposure prophylaxis, "may provide a safety net to prevent HIV infection," said Dr. Ronald Valdiserri, who oversees HIV prevention at the U.S. Centers for Disease Control and Prevention.

The CDC has previously recommended the month-long antiretroviral therapy only for health workers exposed on the job to HIV. The regimen appears to stop the virus from taking hold in newly exposed people.

With the expanded guidelines, Valdiserri told a news conference Thursday, the treatment -- which is expensive and prone to side effects -- should still only be reserved for people who normally stay out of trouble.

"We're not putting this forward in a light way. We're putting it forward in instances where there's a high-risk exposure, but the patient is not someone who's consistently engaging in high-risk behavior," he said.

According to Valdiserri, an estimated 40,000 Americans become infected with HIV each year. Death rates have dipped during the past decade, however, because of a new generation of powerful drugs, and researchers think those same drugs can stop the infection process if taken immediately after exposure.

The federal government's guidelines, first issued in 1996, suggested that health-care workers exposed to the virus -- perhaps through a stick with a contaminated needle -- could try to prevent infection by taking AIDS drugs no more than 72 hours later. Research suggests the treatment prevents 80 percent of infections from taking hold.

Because the guidelines aren't binding, however, some doctors have used the same treatment on patients who reported having unsafe sex, perhaps because a condom failed or they didn't use one in the first place.

Dr. Lisa Grohskopf, a CDC epidemiologist who specializes in HIV, told the news conference that the CDC is now comfortable recommending the treatment for a wider group of individuals.

"People who would benefit include those who occasionally lapse in safe-sex or drug-use behavior, or are exposed through assault or accidents, or who experience condom slippage with a partner who's HIV-positive," she said.

The CDC recommends that in such instances, a person take a combination of three AIDS drugs for 28 days after exposure. The entire treatment typically costs $600 to $1,000, Grohskopf said.

The drugs do have side effects, however, including nausea, headaches, vomiting and diarrhea. Less common side effects include liver problems and allergic reactions. And Grohskopf emphasized the treatment isn't 100 percent effective; some people will still get infected.

She also emphasized the treatment isn't for everyone exposed to HIV.

"It is not recommended for individuals whose HIV-exposure risk is negligible, or those who seek care more than 72 hours after suspected exposure," she said. "It's also not recommended for people whose behaviors result in frequent exposure to HIV: those with HIV-infected sex partners who rarely use condoms, drug users who often share equipment."

Critics have questioned the post-exposure treatment, asking why AIDS drugs should be used to prevent infection that may not even have occurred. They argue the money could be better spent to treat HIV-positive people around the world who have no access to medication.

Some AIDS specialists have also wondered if people will be more careless about protected sex if they know they can take the post-exposure treatment as a backup.

Valdiserri warned against careless use of the post-exposure therapy. It's "a complex regimen that should not be used as a substitute for behaviors that can help avoid HIV exposure in the first place," he said.

More information

Learn more about post-exposure HIV treatment from AIDS.org.

Read this Next
About UsOur ProductsCustom SolutionsHow it’s SoldOur ResultsDeliveryContact UsBlogPrivacy PolicyFAQ