In a recent post applauding news that HIV medication makes HIV-positive men far less likely to spread the virus to partners (a sentiment I heartily endorse), Andrew Sullivan ponders a question I find genuinely perplexing:
But I wonder what the full effect would be if all men diagnosed with HIV were immediately put on retrovirals and all HIV-negative men were put on a basic anti-retroviral at the same time.
I bet you’d see a sizable decline in HIV transmission.
I can only guess that he means “all HIV-negative men in relationship with HIV-positive partners,” in which case this makes sense as a means of primary prevention in the spread of HIV. I’m really hoping that’s what he means. If he’s suggesting that all HIV-negative men be put on prophylactic HIV medication as a way of preventing infection, this strikes as a real head-scratcher. HIV medications are costly, and even the most benign are not free of side effects. Avoiding unprotected sex with poorly-known partners strikes me as a much better preventive behavior, one that is far cheaper, healthier and saner.
Here’s hoping he mistyped.
Perhaps showing my ignorance, but wouldn’t using retrovirals that widely greatly increase the prospect of retroviral-immune HIV strains?