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Tell them that compliance is critical, regardless of "how they feel," and as long as the risk persists, keep their future in the front of their thinking. PrEP - or, if that is too elaborate or expensive, PEP for post-exposure - raises consciousness far better than condoms, and it's consciousness which will cure the epidemic well before science has better solutions.
one has to wonder if you believe in editing. that first sentence is utterly contradicted by the depth of fury in your tone...unless your tone is meant as a lampoon of Michael Weinstein, head of the AHF and someone who would probably be called "seriously opposed to PrEP" by most astute observers...tho one can always make the ninja-case (and some people have) that he's always been in the pocket of Gilead and only attacked PrEP to discourage widespread use of it and thus avoid any downward-pricing pressure upon Gilead. if your screed was meant to lampoon Weinstein's over-ripe, preposterously sex-negative tone, kudos. have a biscuit or a scone. i especially liked the supposition that trying to avoid a potentially deadly infection while engaging in physically unencumbered, natural sex is some sort of "recreational" activity. zomglulz that can be deconstructed sooooo many ways...it gets me EVERY time! bravo! i'm glad you're not "serious opposition"!
Oh please, can we stop pretending that there's some serious opposition to this pill? It has been obvious since day one that PrEP was inevitable. Already we're seeing phrases like "we won't end the epidemic without PrEP". LOL what? I'm sorry, have we forgotten about a cure, which is the only working model we have, or a vaccine, which has historically been the only economical way to eradicate a disease? WTF??? No one with a brain thinks PrEP is going to decrease HIV infections. Not straight people, not seronegative gay men, and not people who are poz and are honest about how they came to be infected. One literally has to grasp at straws to imagine this as something other than a recreational drug. Despite this, it is politically incorrect to point out what Gilead is doing here: finding a new use for an old drug to renew its patent, just like we saw happen with Norvir. All of this noise about "resistance" is a red herring. We don't see any evidence of that happening and Gilead clearly doesn't expect it, evidenced by the fact that it's just introduced two more fixed dose treatments containing Truvada. The response that this drug won't take away from existing HIV programs is a straw man, and a pretty poor one at that since any rational observer should now be asking how Gilead can afford to give the stuff away as Prep while gouging insurance companies and public assistance. The real issue is that this drug is an indictment against our pharmaceutical system, and an embarassment to our so called "activists" who've spread their legs for it in exchange for god-only-knows what compensation and a death sentence for hundreds of thousands of gay men who are going to be seeing ads for this in periodicals within the next year. If you're not angry about this, you're not paying attention. How dare you admonish us to "turn down the emotion of conversations regarding prep". We've reached a sad day when people who make their living as "HIV advocates" tell people living with the virus to sit down and shut up.
I feel Prep Is ludicrous at best. Very expensive, plus it does nothing to stop the many other STDs that are running rampant. I say, wrap that rascal for much less money and much more protection against STDs and dont feed the pharms more money, they are rich enough.
Wonderful article David. I certainly hope that people on all sides of this issue will step back, take a deep breath, and rationally observe the results of the demonstration projects that are essential to determine the ultimate effectiveness of PREP and the issues associated with it. As a gay man with HIV, I've come to believe that unconscious fear and unconscious anti-HIV/AIDs, and anti-gay sex, bigotry tends to color so much of the debate on issues like this.
Thank you for such an informative, honest, well-reasoned and sensible article. What a shame that so many people I once respected have chosen to take the wrong side of this issue. The rest of us are moving forward.
If someone who needs the drug to live is paying Gilead 2k a month, but Gilead is giving the drug away for free as PrEP, it reasonably follows that for Gilead to remain solvent, we and these programs are already destined to pay for it, either directly or indirectly.
Joe Beckmann
Fine on PrEP, although we've known about it in general terms for at least 2 years. What about PEP, "community infectivity" due to higher levels of safe testing, and the sharp drop in new cases where there is close to universal health care? Together they suggest an real end to the epidemic, even without a cure.
June 2, 2012