title: A pill for HIV prevention: déjà vu all over again?
abstract: Recent FDA approval of tenofovir-emtricitabine for prevention of human immunodeficiency virus (HIV) as a form of pre-exposure prophylaxis (PrEP) has led to concern about implementation of this strategy. Fifty years ago, a very similar national and international debate occurred when the oral contraceptive pill ("the Pill" or "OCP") was approved. Contentious issues included OCP safety, cost, and the potential impact on sexual behavior--many of the same concerns being voiced currently about PrEP. In this article, we review the social and medical history of OCP, drawing parallels with the current PrEP debate. We also explore the key areas where PrEP differs from its forbear: lower efficacy, presence of drug resistance, and a more circumscribed (and marginalized) target population. A thoughtful approach to PrEP implementation, bearing in mind the historical insights gained from the 1960s, might serve as well as we begin this new chapter in the control of the HIV epidemic.
authors: Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, New York, USA. jmyers@health.nyc.gov
authors: Julie E
authors: JE
authors: Myers
authors: Kent A
authors: KA
authors: Sepkowitz
mesh_terms: D019380:Anti-HIV Agents / Q000266:history* / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002986:Clinical Trials as Topic; D003276:Contraceptives, Oral / Q000266:history*; D015658:HIV Infections / Q000188:drug therapy / Q000266:history* / Q000517:prevention & control*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D019380:Anti-HIV Agents; D003276:Contraceptives, Oral
keywords: HIV prevention; birth control; historical insight; oral contraceptives; pre-exposure prophylaxis