Tuesday, August 26, 2008

MTV - Not your Daddy's music video

One of the great things about being an emergency physician is the ability to see the latest social trends as they are born. As people dream up all new ways of indulging in risky behavior, the consequences are seen in the emergency department. One recent trend that is particularly disturbing is the use of a “party pack” known on the street as MTV. MTV stands for M-ethamphetamine, T-enofovir, and V-iagra. Tenofovir is a powerful antiviral used in the treatment of AIDS. The other two pills are self-explanatory.

In World War II, just after the discovery of penicillin, soldiers would pop a Penicillin pill, then go out to have a good time. There are no scientific studies to prove that this method was effective, but the idea held on with surprising tenacity. Now members of the gay community are using the “party packs” as a substitute for safe sex.

According to author David France in the latest edition of GQ, use of the “party pack” is also known as “taking a T” and has recently enjoyed increasing popularity in the gay and bisexual male community. The problem is, there is no science that proves that PReP (Pre-exposure Prophylaxis) works to prevent HIV transmission. Failure to use a condom in that false belief that PReP works could result in increased transmission of the virus.

It is confusing to me to hear young gay men talk about using a “Party pack” and ignoring the condom. It’s true that with early detection and today’s antivirals, people newly diagnosed can expect to live long lives if they faithfully take the medication. However, AIDS is still a killer. Half a million Americans have died from the disease. About 15,000 people die every year in America, a preventable and tragic event. Globally, there are about 33 million people living with the diagnosis. Another 1.2 million become infected each year. For many years 40 million Americans became HIV+ each year. The CDC is closely guarding the latest figures, but rumors are that there has been a surge, perhaps as large as 52 million, new cases. Since 2001, there has been a 33% increase in transmission of disease in the under-30 gay crowd. According to a recent New York Times article, the largest is boys between the ages of 13 and 19, who show 112% increase in infections.
It would be unethical to perform prospective, double-blinded studies to determine if taking retrovirals before sex can prevent the transmission of HIV. So, until the proof is in, please continue to have safe sex. Use a condom, every time

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