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.