Even though Truvada is praised as wonder-drug in the fight against AIDS, some are saying it’s making common sense go out the window with its use
By Curt Cramer

Truvada is a drug that is used in combination with several others to combats the AIDS causing HIV-virus. It has been hailed by health professionals and AIDS activists as a cornerstone in protecting gay men engaging in sexual activity with the potential for infection. The medication has been around for the better of ten years, and worked so well that in 2012 the FDA approved use of the drug as a PrEP, or pre-exposure prophylaxis. With this feature though, the drug took on a whole new facet – being used as a preventative measure, which led to the assumption that one could engage in sexual activity without the use of the barrier protection in condoms.

Now because of this, the drug is in the center of a divide where doctors are campaigning in large amounts to promote Truvada’s effectiveness and urging those who are at-risk to use it, and others who say the drug promotes reckless behavior, tempting people to have sex without the use of condoms.

In an interview with the Associated Press, Michael Weinstein, president of the AIDS Healthcare Foundation explained, “If something comes along that’s better than condoms, I’m all for it, but Truvada is not that. Let’s be honest: It’s a party drug.”

His words reflect many others in the gay community, who even with recent celebrations of the widening legal acceptance of gay marriage in the US, are fighting the much less publicized debate over Truvada, causing harsh subdivisions and even backlash by opposing sides. Shaming of users had led to such examples as a T-shirt being promoted with the phrase “Truvada Whore” on it. All refraining tensions much like that of the 1960s era debate that the newly found birth control would promote promiscuity.

Medical director for the ambulatory HIV program at Mt. Sinai Hospital in New York City, Dr. Demetre Daskalakis, served on the FDA panel that helped to approve Truvada for preventative purposes. In an interview with Associated Press he said, “I’ve spoken to some of my patients who’d totally be candidates but are hesitant to do it. They don’t want to be labeled as people on the drug because there’s a social stigma.”

According to AP, he called the drug a “slam dunk” for those having significant amounts of unprotected sex since the drug not only helped prevent infection, but also engaged the users in regular HIV testing, helping the medical side as well. But, of his large clientele, only about 25 are Truvada users for prevention purposes. Daskalakis is disappointed in much of the opposition to the drug, like that of the aforementioned AIDS Healthcare Foundation’s statements that Truvada usage condones condom-less sex, saying, “If some men don’t want to use condoms, they won’t. You have to deal with it by acknowledging that sometimes unprotected sex happens, and you can still prevent HIV infections.”

Regardless, the figures by Gilead, the maker of Truvada, reflect the somber tone over the push for usage. The company reported 1,774 people started using Truvada for prevention between January 2011 and March 2013. The downside for proponents in the current debate? Nearly half of these were women using the drug.

Yet another face of the current challenge in getting at-risk individuals involved with PrEP plans is raising awareness of those in the black community with high infection rates.

“We have young minority men becoming infected at disproportionately alarming rates, and now we have something that could avert this,” said Lynnette Ford of GMHC, a New York City AIDS service organization. “But there’s not a lot of information out there in communities that need it most.” (Associated Press)

With more awareness and direction on safe usage of Truvada with the use of condoms, the drug seems to be a perfect ingredient to preventing and ultimately lowering infection rates in the US – which currently number around 50,000 a year – but the stigma of being a “slut” on the drug, along with the discontent of its needed regular routine of usage, is ultimately preventing people from using. New York psychotherapist and avid Truvada user Damon Jacobs told Associated Press, “A lot of doctors are still under the belief that if they give their patients PrEP, they’ll go out and have condom-less sex. What they don’t understand is that gay men are already doing that.”

-Curt Cramer (@CurtisRemarc)