HIV Pre-Exposure Prophylaxis and Sex Work in Canada 2016

looks at safety and side effects. So, across the board, it’s about 1% to 10% of people
experience some side effect. The most common is gastro-intestinal.
Q But how long have they been researching it? Five years?
A Camille: In 2010 the first research on oral PrEP was released, so I guess, since 2004
or 2005 is when they started the research. It’s considered to be a significant body of
evidence, and Truvada® is considered to be fairly safe and well-tolerated, for the most
part. But it’s true, most HIV-negative people taking PrEP—it’s so new—haven’t been
taking it long term so we’re not really sure. I would say that it’s acknowledged within the
research community that it’s a safe drug to take, for most people. But ongoing monitoring
is really important to identify and deal with any negative side effects.
Q Are you aware of any ongoing longitudinal studies right now of people who are taking
PrEP—HIV-negative versus HIV-positive folk who have just been taking the Truvada®?
Because I’ve heard, anecdotally, from folks who were taking it, often side effects happen
when people are first taking drugs—whether it’s the gastro-intestinal or whatever. But
the things like renal issues or the bone loss stuff, that comes with long-term use. Sure, if
you’re first taking it can be reversible, but what about long-term?
A Camille: Right now, the studies are ongoing. Lots of
researchers are trying to study PrEP in more “real world”
settings, outside of the clinical trial setting—like people using
PrEP in local clinics—and every study is looking at safety and
every study wants to be able to say something about how the
drug is affecting the people who are taking it. So I think over
the long-term we will know more, but right now, what we
know is that it’s relatively safe. There may be longer-term
effects, but, in the short-term, at least, any negative effects
appear to be reversible when the drug is stopped, too.
Q So, for example, my man has got hep C, and say for
example I have HIV, so he’s going to start taking the PrEP
pill. Now, at the same time, he’s going through the new drug for hepatitis C treatment.
How’s that going to affect everything? And on top of that, there’s also a question of
taking the HPV vaccine which is another six-month, three-times deal, so can you combine
all of those things with a drug like Truvada®?
A Camille: I would suggest he talk to his doctor or care provider.
Q If I could interrupt. My partner’s just finished sofosbuvir. He’s just cured of hep C.
Really, really amazing. We went into the research about—it’s a rather lovely word—
“pharma-co-kinetics.” This is the word for drugs combining, so the pharmacokinetics of
Truvada® and the pill etc. And the pharmacokinetics of sofosbuvir and interferon had not
been studied because we looked completely into it to see about what Truvada® means.
Medical science doesn’t know if you can take Truvada® with the hep C medication, so if
your GP down the corner says he knows, he’s not telling you the truth. There is no answer.
[“Coadminstration of tenofovir disoproxil fumarate and Harvoni® (ledipasvir/sofosbuvir)
has been shown to increase tenofovir exposure.” U.S. FDA MedWatch. Feb. 2016. -Ed.]
Q When I see the words, “Cameroon” and “Cambodia,” I’m wondering how many
Caucasian people took this drug. I find this a very distressing subject because a lot of
birth control is tested on third world women. I’m just saying over the years I’ve seen
how pharmaceutical companies have used vulnerable human populations. I’m kind of
wondering, Cambodians, Africans, and who else has really taken this drug?
A Camille: It has been tested in a number of countries including the U.S. and the U.K.
and countries in Africa, Asia, and South America. So, there has been a pretty diverse
sample with all the research pooled together.
Q How many of the studies were conducted by the drug company themselves versus
independent studies?
A Camille: None of the studies up to now were conducted by the drug companies.
However, Gilead, the pharmaceutical company that makes Truvada®, is about to start a
study looking at a new formulation of oral PrEP, which was mentioned earlier.
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