[cogman10]

It's a solved problem if you are someone that knows you'll be exposed to HIV in the very near future and you have the money and wherewithal to purchase PrEP before that event (and you can plan the event 7 days out).

The power of a vaccine is you can give it to adults and kids before they are sexually active and protect them, potentially, for the rest of their lives.

I'd also be curious to know if the combination of ART + the vaccine might cure someone of HIV. Which is also a pretty big deal.

[compass_copium]

This is completely inaccurate. There is PrEP that requires dosing two times a year. You can also get PEP if you engage in a risky activity without PrEP.

[SietrixDev]

Yes, it exists, but how available is it really? If I recall correctly, the injections are also not very pleasant.

"Gilead sells LEN at very high prices (over $28,000 per person per year in the US), severely restricts its supply to certain countries, and refuses to sell it directly to Doctors Without Borders/Médecins Sans Frontières"

Source: https://www.doctorswithoutborders.org/latest/campaigns/acces...

[sroussey]

The shots are expensive, but the pills are free in the USA. They do have adverse kidney issues over prolonged use (more for some people than others).

[cguess]

And clearly only the people in the USA matter.

[whimsicalism]

Are you serious? I would bank money on PEP being practically free in sub-saharan Africa.

[cguess]

*PrEP

It... was, until Musk dismantled USAID and Congress defunded PEPFAR.

So many comments by people who have never stepped foot out the Global North making wild assumptions.

[matharmin]

That PrEP is in some ways similar to a vaccine, and there is still a lot of value in getting a better vaccine (cheaper and/or lasting longer).

[lopis]

Also, PrEP pills can have side effects long term. And distributing huge amounts of daily pills to remote areas of the globe is much harder than the patients getting a shot on their yearly medical visit.

> I'd also be curious to know if the combination of ART + the vaccine might cure someone of HIV. Which is also a pretty big deal.

"Cure" in the sense they could become indefinitely under detectable levels. It's worth noting that to really cure a person of HIV you'd need to remove all mutated cells.

[cyberax]

PrEP is effective even when taken after the event. The approved protocol is to take a loading dose (2x the normal dose) and then follow up with regular doses for 3 days.

[simonask]

Ad-hoc use of PrEP just requires that you take a double dose 1 hour prior to potential exposure, and follow up with another double dose 24 hours later, at least with the versions commonly prescribed to sexually active groups in my area.

I agree that a vaccine is another game-changer, but it’s extremely important that we don’t spread misinformation about the efficacy and convenience of PrEP. In developed societies, it has already all but eliminated new transmissions among groups that were previously most at risk.

[tallanvor]

At least 2 hours before, not 1, and preferably closer to 24 hours before.

[jcul]

Does this double dose completely prevent infection?

[cyberax]

It's called a "loading dose" and it's a common trick in medication dosing.

If your drug has an elimination half-life of 1 day, then it takes about 4 days to reach the steady-state concentration if you take normal doses. With the loading dose, you immediately reach it.

[matthewmacleod]

The evidence I’m aware of suggests that this method (on-demand or event-based PrEP) is broadly as effective as daily PrEP (though it’s not suitable for vaginal sex). I believe adherence rates are generally lower though, as people can find the instructions confusing, and it’s obviously easier to mis-dose than a daily regimen.