World Health Organization Adds Its Support to PrEP

The World Health Organization (WHO) has added its voice to the growing call for HIV-negative gay men to take daily medication to protect themselves from the disease.

In its updated guidelines for HIV treatment, diagnosis and prevention, WHO states that “pre-exposure prophylaxis” (PrEP) “is recommended as an additional HIV prevention choice within a comprehensive HIV prevention package.”

The PrEP approach requires that an HIV-negative man take a pill daily that includes Truvada, an anti-retroviral medicine. Studies show that Truvada, when taken for seven to 10 days in a row, can dramatically reduce the risk of infection for HIV-negative men who have unprotected sex with HIV-positive men.

WHO says that PrEP “is best offered as one component of a comprehensive set of HIV prevention interventions.” Those include “unfettered availability of condoms and lubricants, routine HIV testing, risk-reduction counseling and adherence coaching if PrEP is offered.”

The announcement by WHO, the international health agency of the United Nations, is the latest major endorsement of the PrEP strategy. In May the federal Centers for Disease Control also endorsed PrEP as a way to reduce HIV infection.

PrEP also has been in the headlines recently with New York Gov. Andrew Cuomo’s endorsement of it as a tool in his campaign to dramatically reduce HIV infection in his state.

While it has its supporters, the PrEP campaign also has its critics. Chief among them is Michael Weinstein, whose AIDS Healthcare Foundation is the largest non-government provider of HIV services in the world. Weinstein has expressed concerns that gay men won’t use Truvada consistently and will see it as a substitute for the use of condoms. He and others argue that a relaxation in use of condoms will increase the transmission of sexually transmitted diseases such as syphilis and gonorrhea. And inconsistent use of Truvada in a culture in which condoms aren’t viewed as the main HIV prevention tool may increase HIV infection.