> I understand why - early drugs like AZT were even harder on the patient's liver than modern drugs. But at best that seems myopic; at worst, it was negligent from a public health perspective.

Today we have drugs that prevent the initial infection of HIV, they're dubbed pre-exposure prophylaxis drugs. The only drug approved for this use in the US is a formulation called Truvada. It can cause bone and kidney damage, and is contraindicated in patients with renal impairment. Gilead, the drug's manufacturer, has risen the price of the drug from $6 to $1600 a month.

Other formulations, such as Descovy, have less of an impact on the renal system. Gilead has been sued for allegedly withholding the drug in order to time its introduction with the expiration of Truvada's patent in 2021[1].

Truvada's pricing, side-effects, and contraindications keep it from reaching many of those who are at risk of becoming infected with and transmitting HIV. Alleged patent timing is preventing the release of safer drugs that are just as effective. While we've come very far, we still haven't escaped negligence from a public health perspective.

[1] https://www.marketwatch.com/press-release/mass-tort-alleges-...