Wednesday, May 21, 2014

This pill could stop 90 percent of HIV cases in the US

But only if it reaches the right people 

Michael Lucas has been taking Truvada, the HIV prevention pill, for about a year now. And the 42-year-old adult film director and gay porn performer readily admits that the decision wasn't all that hard to make — especially when compared with the alternative. "It just seemed healthier to run the risk of experiencing side effects than to worry about HIV," he says, adding "I come from a generation where people were dying all the time, so I grew up living in fear."

Lucas is part of a small but growing subset of HIV-negative gay and bisexual men who have embraced Truvada, the most widely used incarnation of an HIV preventative drug regimen called PrEP. The little blue pill, which is taken daily and costs $13,000 a year (but is covered by most insurers), helps reduce infection rates by more than 90 percent. But until recently, only a select few were aware of the drug's existence as an HIV preventative. The US government's announcement last week that it was urging physicians to prescribe PrEP to anyone who might be at risk for HIV infection — not just men who have sex with men who might be HIV positive — therefore came as a surprise.
"Soon every gay man will be taking this drug."
"If broadly followed," The New York Times wrote, "the advice could transform AIDS prevention in the United States." Slate took a less nuanced route, referring to the pill as a "miracle drug." But Lucas is even more adamant about the drug's HIV-eradicating potential. "We are there now. This is the breaking point," he says. "Soon every gay man will be taking this drug and we won't have HIV spreading any longer — it'll be over."

These statements are both beautiful and revitalizing — a tone that is, unfortunately, rare in the media's coverage of HIV prevention. But in their rush to embrace a preventative method that is indeed remarkably effective, many missed an opportunity to move the conversation surrounding Truvada forward. 

Beyond the guidelines

"We know that the medicine works, it's proven," says Jay Laudato, executive director of the Callen-Lorde Community Health Center, which provides healthcare to New York City's LGBTQ communities. "But what was shockingly missing from the government's announcement was ‘how do we integrate this drug into peoples' lives?' and into HIV prevention plans in general." He thinks the drug is a good fit for some people, but Laudato says it's not right for everyone who might be part of an "at-risk" group.

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