Black market for Truvada PrEP may undermine treatment adherence in marginalised people living with HIV

The increasing demand for pre-exposure prophylaxis (PrEP) is likely to increase the likelihood that some marginalised individuals living with HIV interrupt their own treatment to sell some of their prescribed medication to pill brokers and drug dealers, according to a study presented to the Conference of the Association for the Social Sciences and Humanities in HIV in South Africa last week.

Dr. Steven Kurtz said that several reports have documented street markets for diverted antiretrovirals (ARVs) in the US. In his study of men who have sex with men, people who didn’t sell their drugs also reported being approached by traders. Less frequently, ARVs were sold or given to individuals who would use the pills themselves, sometimes in exchange for recreational drugs or sex.

There was little evidence that individuals purchased ARVs from the black market for self-treatment of HIV infection, but that the illicit use of Truvada for prevention purposes has been documented. Many HIV-negative people who are at high risk of HIV infection do not have health insurance, perhaps making them more likely to turn to the black market.  “The potential intersection of widespread ARV street markets and misinformed at-risk populations about the effective use of PrEP is a major public health concern,” Kurtz concluded. Read More