[Geimfari]

The drug has several non-minor side effects, is prohibitively expensive, and is the same as the treatment for someone who already has the virus. I for one think it's improper to prescribe a drug with these nephrological side effects to a large number of otherwise healthy individuals, not even accounting for the cost.

[jdietrich]

If it weren't for Gilead's legal efforts to extend the patent on Truvada, it'd be a dirt cheap generic by now; it already is in many countries.

You might think it's improper, but the evidence says otherwise - PrEP is safe, well-tolerated, marginally cost-effective at proprietary prices and clearly cost-effective at generic prices.

One of the fundamental principles of modern medicine is informed consent. Patients have the right to make their own decisions about their treatment based on their own assessment of the risks and benefits. PrEP is an incredibly compelling proposition for a lot of patients.

https://www.who.int/hiv/topics/prep/en/

[verulito]

I think PrEP is great and I don't think we do a great job of getting it to people for whom it makes sense. That being said, the CDC has an excellent position on who should be getting it and that's not a lot of people.

PrEP is well tolerated given it's known side effects but conservative medicine dictates that we don't prescribe medications unless we have a measurable benefit and that's not a large group of people. A homosexual male who has lots of unprotected sex with strangers should probably be on it. A hetereosexual mostly monogamous person probably shouldn't be.

A big factor here is that the prevalence of HIV in the US is low, at .34%. Globally it's a bit higher at .48%. It is also often not that contagious. That being said, under the right circumstances it could be so it's real important to be aware of the risk factors.