From the Guardian.com…

Two years ago, James Krellenstein had unprotected sex. Luckily, the 22-year-old knew exactly what to do. The next day, he took a train from his parents’ house on Long Island to see a doctor at Bellevue Hospital inNew York City. The doctor prescribed James PEP – a strong combination of drugs usually prescribed for people who already have HIV. Months later, Krellenstein found out his partner from that night was indeed HIV-positive. But James remained negative. PEP’s little-known effectiveness in preventing the virus taking hold in someone’s body has led it to be dubbed the “morning-after pill for HIV”.

Yet Krellenstein’s experience remains rare. While the idea of treating people who may have been exposed to HIV with PEP has gained ground among doctors and activists over the last few years, most local governments in the United States have yet to implement a comprehensive PEP distribution or education program. That’s left many who are most at risk from contracting HIV unaware the option even exists. Now, as HIV diagnoses continue to rise among gay men, activists and experts are urging governments to invest money in PEP awareness campaigns and treatment programs. Otherwise, they say, many communities might be heading for a new HIV and AIDS crisis in coming years.

“We’re going to have to deal with [HIV] one way or another,” said Krellenstein, a member of the HIV awareness and activism group Act Up. “And I’d rather do it on the prevention side rather than waiting for everyone to be positive.” Krellenstein’s concern about “everyone” contracting HIV may sound like hyperbole. But if current infection rate trends continue, 54% of all men who have sex with men (MSM) will have HIV by the time they are 50, according to a 2009 University of Pittsburgh study. Among African American men who have sex with men, half will have HIV by the time they are 35. And while contracting HIV is no longer a death sentence, many worry that the increasing incidence of infection will burden the already-strained US healthcare system. The lifetime cost of treating someone with HIV can reach over $1m.

Those staggering numbers are what’s led groups like Act Up to campaign for increased funding for PEP, and increased awareness within the gay community. Act Up’s involvement is notable. The group made a name for itself pushing for politicians to take the HIV crisis seriously in the 1980s. But as treatment for HIV improved, gay marriage and other social issues replaced health at the forefront of the LGBT rights movement, and Act Up faded from view. Now, the group has found renewed purpose in calling notice to the increasing prevalence of HIV and the lack of funding for unorthodox solutions like PEP. While no one in Act Up thinks PEP is a cure-all in the ongoing fight to stop the spread of HIV, many believe it’s a missing piece in comprehensive “prevention pipeline” that includes condoms, regular testing, and education.

“A lot of young gay guys, even well-informed ones, don’t know a lot about HIV,” said Jim Eigo, an activist with Act Up who also petitioned governments to take action on HIV in the 1980s. “We’ve got to open up the eyes of the gay community … and say if you’re HIV-negative, there’s an individual value and a community value in staying that way.”

Continue reading the full article here.