Pre-Exposure Prophylaxis for HIV

I felt like starting a thread about PrEP (a once a day pill that prevents the acquisition of the virus in confirmed HIV-negative people) that is, at least, initially not hinging on Larry Kramer's name and reactionary stance of a couple of months ago.

I have been following the coverage fairly closely and I would have to say that the American media obsession with having to have a voice from "the other side" on every story that is about the advancement of gay rights or the sex lives of gay men is terribly wearying.

A lot of the "other side" in the discussion of PrEP, or Truvada as Pre-Exposure Prophylaxis for HIV, has come from Michael Weinstein, whose billion-dollar AIDS Healthcare Foundation took out anti-PrEP ads in major papers, including in Washington DC. I can't quite get to the bottom of what his investment is in undermining this development of an effective HIV prevention tool to put in the arsenal of ways to stop HIV. The cynic in me wonders if he fears an end to new clients for his agency if the epidemic is stopped?

Anyway, in my travels on the topic today I found a GREAT article that looks at the phenomenon and the American myths it plays into. It really resonates with me.



PrEP and The Moralization of Calamity

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Updated On: 11/19/14 at 05:45 PM

And that impulse has yet to change.

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Mine would be low if only anal counted. As for everything else, well, only I and a few dozen others per month know for sure. That's why this sentence really resonated for me:

"Science describes HIV infection as a matter of odds, which implies that many of those not infected engaged in some of the same behaviors we shame, and simply got lucky."

My repeated negative tests have reinforced a notion I can summarize as "I must be doing something right," which is correct but only as a far as I can admit it includes a great deal of luck. It's probably a relatively low number, but there's no way I haven't engaged with guys who have no idea they are in the earliest (and most highly "infectious") stage of HIV seroconversion.

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It's an in-polite-company understatement.

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There's no answer to the evil profit that "Pharma" makes out of getting every gay boy in the United States (and then the world) to be taking this as a once-a-day like a vitamin. Whether insurance pays for it or mommy and daddy's trust fund pays for it or you make enough money to pay for it, the drug company gets between $8,000 and $12,000 per year per patient. That translates into gazillions of potential dollars.

That conversation goes nowhere except to cynicism and the same-old prevention strategies we've been hawking since poppers were ruled out.

And still the 20somethings get infected.

If you're going to talk about this at all, you really have to drop that cynicism and look at PrEP as a new paradigm of prevention strategy: X% of the number of people taking PrEP and following the protocol including the 4X yearly doctor visits will NEVER seroconvert.

Whether that number is 50% or 99.99&, it's probably way better than condoms.

Namo's heard me say this before, but I wish, I wish, I wish, that Pharma had come up with a cure or a onetime vaccination.

But this is what we got, and taken correctly, it can prevent infection.

What to do about the drug company's windfall profits?

I dunno. Buy Gilead.

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Updated On: 11/20/14 at 10:51 PM

PJ - my personal reason for - currently - having no personal interest in PrEP is not so much about my reluctance to support the massive profits of big pharma, but about their shocking ability to get unsafe drugs approved and to then, years later, settle death and injury cases while still maintaining a healthy profit. I'm not a conspiracy nut. I don't believe big pharma is "evil" and out to get us. I'm sure, like most people, I know friends and family members who are alive and living better lives because of medical advances from the pharma industry. I'd just rather have other people be the guinea pigs for a few years before I'd consider taking it myself. A selfish, illogical, highly emotional reason? Sure.

I LOL'd too.

I'm not trying to make a point here about anything other than to offer my (unsolicited) reasoning for having no interest in Truvada at this time. In no way a moral judgment about those who choose this option. I think it's a wonderful advance and should be celebrated. And I may join in in a few years myself.

AHF seems to have a pretty weak rebuttal, that people may not take it every day and you still can get other STIs if you then go condomless?!

Seems pretty straightforward that if you don't take medication as prescribed, you wouldn't get the desired effect, and that a pill tat prevents one thing doesn't protect you from other things.

But the new world order seems to be if you can elevate your bull**** to a certain level, people have to discuss the "two sides" as though they have equal value.

It is astounding how obfuscated information about this seems to be. Around the time of the Larry Kramer thread, I was talking to a friend of mine who is a pharmacist about anti-virals being used prophylactically and she looked at me like I was crazy. I had to dig up that thread and show her that I wasn't just pulling this out of thin air.

Updated On: 11/20/14 at 02:06 PM

Yes, another old, white HIV+ gay man has something to say about PrEP (in this case it's Peter Staley, whom everybody loves and who isn't a blocker like Larry Kramer or Sean Strub or the exceedingly odious Michael Weinstein). It's a good article but I am really longing to hear from young HIV negative men and their thoughts about PrEP.


time for anti-science PrEP critics to "shut their traps"?

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