By Mathew Rodriguez
From TheBody.com
After two men on pre-exposure prophylaxis (PrEP) at the Kaiser Permanente San Francisco Medical Center tested positive for the hepatitis C virus (HCV), clinicians at the center penned a letter to the editor of the journal Clinical Infectious Diseases calling for routine HCV testing in gay men who are currently on PrEP. The two men were among 485 HIV-negative gay men receiving PrEP at the clinic between 2011 and 2014.
Both men had a history of several rectal sexually transmitted infections (STIs) while on PrEP and no non-sexual risk factors, such as using injection drugs or getting a tattoo or piercing. While the HCV incidence rate among the HIV-negative gay men at the clinic is much lower than the incidence rate among HIV-positive gay men in general, these findings add to the “larger dialogue about having sex without a condom while on PrEP,” AIDSmeds said in its write-up on the topic.
Jeremiah Johnson, HIV prevention research and policy coordinator at Treatment Action Group (TAG), says that these findings are important to discuss, but that PrEP still holds an immense amount of value for those who wish to take it. “It’s always important for an intervention that we have for HIV to account for some of the potential unintended side effects, but the problem is that we can’t throw the baby out with the bathwater. PrEP isn’t perfect; it’s not appropriate for all sexual risks — neither are condoms.”
Most importantly, Johnson added, we must allow people to mitigate their own HIV risk and choose a prevention method that they are comfortable with. “We have no perfect HIV prevention intervention, so in the meantime we have to find out how to make [condoms and PrEP] work together and have open discussions without shutting it down with hysteria.”
“We’re always going to be looking for potential complications, but that doesn’t mean because PrEP isn’t perfect, we stop using it and expect gay men to adopt impossibly high rates of condom usage. That never worked and it never will. No population uses them 100% of the time,” Johnson added.
The biggest threat for HCV in PrEP users may stem from a lack of clear information on the potential for transmission. “I’m not overly worried, just confused about the risk of transmission through sexual contact,” said Adrian Mills, 29, a PrEP user.
This excerpt was cross-posted with the permission of thebody.com. Read the full article.
