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Cautious approach to HIV post-exposure treatment

Wed 21 Apr 2010 In: New Zealand Daily News View at Wayback View at NDHA

HIV agencies advise caution over an expensive drug treatment programme which may stop the development of HIV infection in those exposed to the virus and could become funded in New Zealand as early as July 1st. Post Exposure Prophylaxis (PEP) is a 28-day long, aggressive drug programme costing $1,300 and until now only formally available to medical professionals who are exposed to possible HIV infection through accidents such as hypodermic needle pricks. However, on rare occasions the partner of a person known to have HIV has been put on the treatment when incidents of accidental unsafe sex or shared drug needle have occurred. Pharmac, the government drug funding agency, is calling for feedback on a proposal to formally fund PEP specifically for people in this situation. The 'known to be HIV positive" limitation is to ensure the treatment is not used in a cavalier fashion as a 'morning after' pill thus lessening the imperative to practise safe sex. High cost and some doubts about the effectiveness of the treatment have underscored this limitation. The NZ AIDS Foundation is supporting the limitation. "The main concern with non-occupational PEP is that there is no definitive research proving its effectiveness," the Foundation's Executive Director Rachael LeMesurier says, "particularly in view of its being a very expensive prevention approach where it is not known for certain if actual HIV transmission occurred because it’s too early for the antibody test." HIV cannot be detected until the body produces antibodies and this can take up to eight weeks and in rare cases even longer. HIV peer support and advocacy organisation Body Positive Auckland believes there could be a serious benefit in making the treatment more readily available for couples where only one partner has the virus which can cause AIDS but acknowledges that not everyone with concerns will be able to prove their sex partner has, or had, HIV. "This is for couples where the risk is known and significant," says Body Positive's Bruce Kilmister. He too believes making the drug more accessible to the broader population carries significant costs which far outweigh the actual risk levels of HIV transmission. "We don't want to encourage the 'morning after' scenario," he says. The AIDS Foundation strongly advises people to maintain their commitment to safe sex and not rely on an unproven treatment. "Not only is it a 28-day treatment, with possibly toxic side effects, it may not work," says Le Mesurier. "Consistent use of condoms and lube has proven to be the single most effective way to prevent HIV, to be far more reliable than PEP and to cost significantly less as well." Pharmac's consultation on PEP closes at 4pm on April 30th.    

Credit: GayNZ.com Daily News staff

First published: Wednesday, 21st April 2010 - 8:29pm

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