"Taking a T." That's what HIV-negative gay men call the growing practice of downing the AIDS drug tenofovir and, with fingers crossed, hoping it protects them from the virus during unprotected sex.
It's being sold in packets along with Viagra and Ecstasy in gay dance clubs -- and even prescribed by physicians, say doctors and AIDS prevention experts. The trend has alarmed public health officials. There is no proof that tenofovir protects against HIV transmission, they say. People who practice unsafe sex while taking the drug could still become infected or suffer side effects from it.
Recreational use of AIDS drugs also might increase overall resistance to the medications, HIV experts say. "This is a very worrisome development," said Dr. David Hardy, an HIV doctor at Cedars-Sinai Medical Center in Los Angeles. He said the drug could lead to an even further erosion of condom use, which studies show has been falling among high-risk populations.
A survey released in July by the U.S. Centers for Disease Control and Prevention, conducted at gay pride events in four cities, found that 7% of uninfected men had taken an AIDS medication before engaging in risky behavior and that about a fifth had heard of someone who had.
Prevention experts stress that the number of men taking the drug in this manner remains small. So far, it appears to be most popular among young gay men who aren't using condoms and people who frequent sex clubs and bath houses.
But health officials say the use is growing quickly. They worry that the practice could spread into other high-risk segments of the population, such as sex workers and IV drug users, and then into the general public. HIV experts, in the meantime, continue to promote condom use as the most effective means of preventing transmission.
"If we find out this works, even in some people, we would never recommend people stop using condoms or reduce their number of sexual partners," said Jeff Klausner, STD prevention director for the San Francisco Department of Public Health. Nonetheless, there is some research that suggests taking the drug prophylactically can reduce the risk of transmission. Based on promising earlier research, the CDC is funding two clinical trials, begun last year in Atlanta and San Francisco, on whether tenofovir, a staple of the current HIV drug regimen, may act as a shield to infection -- much like how a birth control pill can help prevent pregnancy. Each trial is giving 200 high-risk men a daily dose of tenofovir and monitoring them for two years.
