Recent disease trends in public health literature

¶ … AIDS to prevent infection: a bargain?" And is written by Julie Steenhuysen for Reuters and published April 17, 2012. The article begins by describing why AIDS is still a very much-discussed topic within the medical community, despite many breakthroughs, after so many years of being in the news, and so many advances in the technology that treats it. According to the article, one of the most successful treatments in preventing AIDS for healthy individuals is called Truvada, which is a combination of Emtriva, and Viread. (Truvada, 2012) This treatment was created in an effort to create a "pre-exposure prophylaxis" or PrEP. (Steenhuysen, 2012). This treatment would require men who are at high risk of contracting HIV to take a daily pill in order to provide a better defense from this disease.

This treatment may greatly reduce the number of men who contract HIV each year, already at a very high 56,000. The cost of providing a daily treatment of Truvada as a form of prevention would greatly reduce the costs of the nation in treating HIV infected individuals, but may actually be cheaper than not doing so. A study at Stanford University found that giving a daily dose of preventative Truvada would cost $495 billion dollars over 20 years. This cost is enormous and impossible for the state to manage, but if instead of a generalized adoption of Truvada across all sexually active men, scientists now believe that targeting a group of individuals who are at the highest risk of contracting HIV is a potential solution, which would mean specifically targeting those men who have sex with more than five partners in a year. Before this preventative measure can be undertaken, the FDA still needs to approve the drug Truvada for healthy men looking to prevent HIV contraction, rather than intended for those already infected by HIV looking to slow the infection's spread through their system.

The study found that if only 20% of the highest- risk individuals took Truvada daily, then it would prevent 41,000 new infections over the next 20 years, with a cost of $16.6 billion. (Steenhuysen, 2012) Focusing on the most prolific spreaders of HIV will not necessarily eliminate HIV or AIDS, but will certainly make an important inroad towards limiting the spread of the disease to new individuals. The Stanford University scientists in this study found that by targeting this sexually prolific group of men, they could prevent twice as many infections as compared to treating 20% of the general population, at a much-reduced expense by comparison. Hitting the concentrated portions of the population that are most likely to spread the infection to new hosts is a method of trying to find the most effective use of preventative treatments such as Truvada. Medical studies such as this one are exceptional at finding the best direction possible for the use of medicine and money for the treatment of the most difficult disease of the past thirty years. Deciding who should receive this drug and at what cost is not only important for maximizing the efficacy of the medication, but also important for finding the most efficient use of treatments in order to best serve the prevention and treatment of HIV and AIDS.

The use of medication intended for those who are healthy, but at risk due to their lifestyle choices, is a controversial use of resources. The cost of prevention, even with a new drug like Truvada, is far less than the cost of treating HIV and AIDS for those who do contract the infection. Even if Truvada is prescribed to those who would not be at risk of contracting HIV in the first place, the cost benefit of covering those who are indeed at high risk is far less expensive than the cost of the widespread infection of HIV. By using an arbitrary percentage of the population, 20%, the study creates a more realistic impression of the number of men, who are likely to be prescribed Truvada and to take it on a daily basis. Investing heavily into Gilead Science's anti-HIV drugs will also allow further advances in the treatment of this illusive disease to continue over the next twenty years.