Giving doctors guidance on drugs to prevent H.I.V.

From the New York Times

truvadaThe medical school at the University of California, San Francisco, has opened a free telephone consulting service for doctors who are not H.I.V. specialists and want help prescribing the right AIDS drugs for preventing infection in healthy patients.The service, known as PrEPline for pre-exposure prophylaxis line, was announced last week.

In pre-exposure prophylaxis, patients at high risk for H.I.V., such as gay men who frequently have unprotected sex with strangers, ward off infection by taking Truvada, a pill containing two antiretroviral drugs. Uninfected men, if they have doctors at all, usually see general practitioners, who rarely prescribe antiretrovirals. By contrast, doctors at U.C.S.F. have decades of experience in treating H.I.V. because San Francisco was an early center of the outbreak.

The new hotline is aimed at American doctors, but if PrEP is rolled out around the world, it could be a model for other countries, said Dr. Ronald H. Goldschmidt, the director of the school’s clinical consultation center. Since 1993, he said, the center has fielded phone calls from doctors seeking help. Typically, they are obstetricians treating pregnant women infected with H.I.V.; emergency-room doctors treating nurses who have had a needle injury; or patients who had sex with someone they suspect is infected.

South Africa and Ethiopia have sent doctors for training to offer similar services at home, he said; prophylaxis is still rare in poor countries because they are struggling to pay for medicine even for those with advanced AIDS.

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