Some clinicians already offer preexposure prophylaxis to HIV-negative people whose sexual partners have HIV or to serodiscordant couples who can't use other modes of preventing infection.
Further research might identify ways to reduce the frequency and expense of preexposure prophylaxis, Dr. Das suggested, such as perhaps taking FTC-TDF only during high-risk periods of life, similar to the way women use contraceptives mainly during the sexually active years.
The main obstacle for most people will be cost, especially for the low-income or indigent patients Dr. Das sees in her practice.
“I could write a prescription, but I don't know how they would be able to pay for it,” she said. Still, FTC-TDF is “another potential tool in our prevention toolkit.”
The rate of HIV infection has been climbing since the early 1990s in U.S. men and transgender women who have sex with men, especially in black and Hispanic populations, the investigators in the iPrEx study indicated.
In almost all countries, the prevalence of HIV is higher among men and transgender women who have sex with men, compared with other groups.