Further Research Needed Into Male Circumcision, PrEP as HIV Prevention Methods, Editorial Says
"Drugs alone will never keep up with HIV/AIDS if there continue to be four million new infections every year worldwide," a Boston Globe editorial says, adding, "While researchers hope someday to develop a vaccine and a microbicide that women can use to protect themselves, those breakthroughs are several years off at the least. So for now, health agencies will have to rely on other tools to slow transmission of the disease." According to the Globe, the ABC prevention method -- which stands for abstinence, be faithful and use condoms -- is a "sound, low-cost approach to prevention, but it has not proven equal to the challenge." The XVI International AIDS Conference in Toronto last week "put a spotlight" on two new prevention methods -- male circumcision and pre-exposure prophylaxis with the antiretroviral drug tenofovir, according to the editorial. A South African study -- which was published in the November 2005 issue of PLoS Medicine and discussed last year at the IAS Conference on HIV Pathogenesis and Treatment in Brazil -- found that circumcision significantly reduces HIV transmission among men, and "[n]ew studies are underway to learn whether circumcision also protects the female partners of HIV-positive men," the editorial says. Although tenofovir has "shown promise as a prevention method," there are several issues associated with testing the drug -- including conducting trials among high-risk groups, such as commercial sex workers and injection drug users, and the possible development of drug resistance among people who contract HIV while taking tenofovir as PrEP, according to the Globe. "Circumcision and tenofovir could both create a false sense of security," the editorial says, adding, "Health educators will have to make it clear that neither method is foolproof and both should be backed up by the ABC basics." In addition, "[d]onors will have to dig deeper to pay for these approaches if they prove their worth," and "[p]olicymakers should give health officials the flexibility they need to keep this virus from infecting millions more than it has already," the editorial concludes (Boston Globe, 8/22).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.