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James Loduca, a spokesman for the San Francisco AIDS Foundation, praised the advisory panel’s action.

“With this recommendation, we’re nearing a watershed moment in our fight against HIV,” Loduca said. “We know this isn’t a magic bullet, and it’s not going to be the right prevention strategy for everyone, but it could save thousands of lives in the United States and potentially millions around the world.”

Not everyone in the HIV community is so gung-ho about using Truvada for prevention.

Michael Weinstein, president of the AIDS Healthcare Foundation, is among the most vocal opponents. His Los Angeles-based group bills itself as the nation’s largest provider of medical care for HIV and AIDS, and Weinstein’s main concern is that patients won’t take the drug as directed _ a pill a day plus the use of condoms. Misuse could create drug-resistant HIV strains, and lead to more infections.

The FDA panelists acknowledged that concern, and said people should be tested to make sure they don’t have HIV before starting Truvada. Patients who already have the virus and begin taking Truvada could develop a resistance to the drug, making their disease even more difficult to treat.

Justin Terry-Smith, a Washington-area writer with HIV, has different concerns. He took Truvada for four years to suppress his infection. He said he has friends with the AIDS virus in other cities who can’t find the drug, and he worries that making it widely available for prevention could result in shortages and pose problems for patients who need it for treatment.

“There has to much more production of this drug for this to actually go forward,” he said.

His doctor recently put him on another drug regimen _ switching medicines is a common tactic in HIV treatment. But unlike his other HIV medicines, Truvada had no side effects, and he said it needs to remain available for already infected patients.

Sterman said approval of Truvada for prevention would be unlikely to lead to shortages because the drug would be recommended only for people at high risk for getting the virus.

“I don’t think demand for it is going to be that high,” she said.

Truvada’s costs are another concern. But supporters of the drug note that the lifetime cost of treating one person diagnosed with the AIDS virus has been estimated at more than $600,000.

“It’s much more cost-effective to prevent a new infection than it is to treat someone for their lifetime,” Loduca said. “Of course the ultimate goal is a vaccine and a cure but we’re many years away from that.”

Jim Pickett, director of prevention advocacy and gay men’s health at the AIDS Foundation of Chicago, has had the AIDS virus since 1995. He says his medical costs, mostly covered by health insurance, have continually increased since then; his HIV medicines alone cost $30,000 a year.

He took Truvada for a while for HIV treatment and had no complications. Side effects from long-term use are unclear, but some of the more serious complications linked with Truvada include kidney and liver problems.

The potential for those problems shouldn’t be dismissed, but it’s not a reason to reject using the drug for prevention, said Pickett, whose group is not affiliated with the San Francisco foundation.

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