This AP story was more thorough than the competing coverage from CNN in a couple of key respects: It noted that the drugs being tested in these studies may not be available to poor Africans who are at greatest risk of contracting HIV, and that the benefits reported by researchers may not be reproducible in a less structured “real world” setting. We were also pleased that this story provided the raw data on infection rates in the treatment and control groups rather than relying on relative comparisons.
The new research reported here adds to the evidence that antiretroviral drugs can prevent transmission of the AIDS virus. These are exciting and newsworthy results, but they are far from the end of the story. As the AP notes, we don’t know whether people at risk will have access to the medication or, perhaps more importantly, whether they will use it. After all, condoms are a cheap and highly effective means of preventing HIV transmission — but their use is far from optimal. It remains to be seen whether people will find it easier to take the daily pill studied in these trials.
Cost is one of the factors driving the supply problem mentioned above (i.e. people can’t afford the drugs without assistance), but the story didn’t explicitly address this.
Although these drugs are available cheaply in developing countries (less than $1 per pill according to some estimates), even these modest costs can put them out of reach in the poorest countries where they are most needed. In the United States, the cost of daily treatment with Truvada (one of the medications studied which contains a combination of emtricitabine and tenofovir) can add up to some $13,000 annually. The story should have referenced cost as one of the obstacles to any large-scale new prevention effort.
The competing CNN story didn’t address costs, either, but health care stories often ignore costs – more than 70% of the >1,500 stories we’ve reviewed get unsatisfactory grades on this cost criterion.
The benefits are clearly explained using both absolute and relative terms. For one of the studies, the story noted,
Any story about drug therapy should include a comment about potential harms. This story did not comment on the safety of the medications tested or potential adverse effects. It failed to mention that individuals taking medication reported higher rates of nausea, vomiting, and dizziness.
The story provides a bit more context that the competing CNN coverage. Importantly, it raised questions about whether the study results could replicated out in the real world when it asked: “How many people would want to take a pill each day to reduce their risk of HIV infection? Would they stick with it? Would they become more sexually reckless?” The story also pointed out that all study participants received counseling and free condoms, which may have helped keep the infection rate low.
Despite these strengths, the story falls short of a satisfactory for failing to point out an important limitation: Because these study results were released in press statements ahead of a major AIDS conference, they haven’t yet been subjected to peer review by outside experts.
There was no disease-mongering in this story.
An independent WHO source is quoted, and there don’t appear to be any conflicts of interest that should have been pointed out to readers.
This story does give the reader a hint about alternative strategies in the last line. Unlike the competing CNN coverage, however, the story didn’t explicitly list alternate approaches that are effective for preventing HIV transmission, including microbicides, vaginal gels, clean needles, medical male circumcision, early treatment, counseling, testing, condoms and suppressive therapy for pregnant women. A tough call, but we think a bit more information should have been provided to merit a satisfactory.
This story makes it clear that availability of the drugs tested in these studies is a problem: “In Africa, 6.6 million people are taking AIDS drugs, but nine million people who are eligible for the treatment are on a waiting list, according to the World Health Organization. In the United States, many state assistance programs that help people get AIDS drugs also have waiting lists.”
Like the competing CNN coverage, this story mentions earlier research showing that Truvada was effective for preventing HIV infections in men who have sex with other men.
The story acknowledges that a quote it uses from a WHO expert came directly from a press statement. Another quote and paraphrased comments did not appear to come from any press release. We think the story does enough for a satisfactory here.