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Truvada Helps Couple Cope With Reality of Love and HIV

ByCARRIE GANN, ABC News Medical Unit
May 18, 2012, 8:25 PM

May 21,2012— -- Nick Literski, 45, and Wes Tibbett, 39, have been together for six years, and their bond is strong. But when Tibbett was diagnosed with HIV in 2009, it was a major blow to the Seattle couple. Tibbett became terrified of giving the virus to Literski.

"I was heading down the road of not wanting to be around anymore because I felt too unsafe to be around him. I was too afraid of infecting him," Tibbett said.

"When Wes became positive, it was a strain for both of us," Literski said. "It's actually very common for people to break off their relationship when one partner contracts HIV."

According to the U.S. Center for Disease Control and Prevention, correct and consistent condom use greatly reduces the risk of HIV transmission. So does being in a monogamous, long-term relationship. But Tibbett and Literski still worried.

Then both men started taking a daily pill, Truvada. Tibbett took it as an HIV treatment six months after he was diagnosed, but in November 2010, the couple's doctor suggested Literski start taking the pill to prevent infection. The men said the drug took the weight of worry about the virus out of their relationship.

"Condoms don't always work. Sometimes they break," Tibbett said. "If we're intimate and I have an accident, I'm not as worried for Nick."

Last week, an advisory panel recommended Truvada for approval by the U.S. Food and Drug Administration as a tool for HIV prevention, a landmark in the 30-year fight against the deadly virus.

Truvada was previously approved for treatment of HIV, and some people, like Literski, got the drug off-label as a prevention method. But the advisory committee's vote officially recommends the use of the drug for preventing infection.

Proponents hailed the committee's vote on Truvada as an historic step in the fight against HIV/AIDS, but critics say the drug has the potential to create a false sense of security for those at risk, perhaps leading them to practice safe sex less diligently, thinking they are protected by the drug.

"I think it will be a catastrophe for HIV prevention in this country," Michael Weinstein, president of the AIDS Healthcare Foundation, told ABC News after the vote. "Men don't need more excuses not to use condoms."

About 1.2 million Americans have HIV, according to the CDC. Nearly half are men who have sex with men.

Dr. Rob Killian, doctor for both Literski and Tibbett, said concerns that Truvada could create a false sense of security are valid. But he said physicians can lower the risk by prescribing Truvada carefully and responsibly.

Killian said he's only prescribed the drug to five HIV-negative patients in the past two years, and only to those who understand that the drug should be used along with condoms, who do not abuse drugs and alcohol and who understand that the pill must be taken every day in order for it to be effective.

Studies have shown that Truvada cuts the risk of HIV infection by 44 percent in gay and bisexual men in conjunction with condom use and counseling. The risk of infection was reduced by 75 percent in heterosexual couples with one HIV-positive partner.

But Killian said an equally important role of Truvada is that it can lessen an HIV-positive person's anxiety that they might infect their loved one.

"My experience with people who are HIV positive is that those individuals usually have more worry and guilt about protecting their partners," Killian said. "One of the main reasons I started prescribing Truvada was to reduce that kind of anxiety."

Tibbett and Literski said the FDA's approval of Truvada was a "huge relief," not only for them but for other serodiscordant couples -- one person with HIV and one without -- who will now have an easier time obtaining the drug.

They said they the belief that Truvada could actually increase HIV transmission by lowering inhibitions is false.

"The people who are going to throw caution to the wind are the same people who would take risks regardless," Literski said.

By consulting with a doctor and strictly sticking to taking the pill every day, the couple said they believe their relationship is safer and stronger.

"It gives me a peace of mind to know that I'm not going to harm my partner. That's a pretty big bonus in anyone's relationship," Tibbett said.

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