Michael Weinstein, the president of the Los Angeles-based AIDS Healthcare Foundation is not necessarily who you’d expect to be standing up against Truvada – the medication created to prevent H.I.V.
Truvada is used as pre-exposure prophylaxis, or PrEP. Weinsteing has called it “a public health disaster in the making.” Starting this week, the AIDS Healthcare Foundation is taking out advertisements in gay-oriented newspapers nationwide with the headline, “What if you’re wront about PrEP?”
Weinstein’s argument is that Truvada could essentially be used as a party drug and promote unprotected sex. But he seems to be one of the only people opposed to the drug who is really speaking out, and people are responding.
“There’s no large controversy; there is one loud voice,” said Charles King, the president of the H.I.V. nonprofit Housing Works and a co-chairman of an anti-H.I.V. task force appointed by Gov. Andrew Cuomo of New York. Mr. King called the A.H.F. ad “a direct attack on New York State’s efforts to end AIDS as an epidemic.”
“I consider him a menace to H.I.V. prevention,” said Peter Staley, a veteran activist who also serves on the Cuomo task force.
Others opposed to Weinstein’s anti-PrEP notions are the World Health Organization and The CDC, but other organizations are with him on this. It seems to be more of an issue about adherence to use of the prescription and how it affects other preventative recommendations, like condom use. But even Weinstein doesn’t say the medication doesn’t technically work – he’s just not on board for the use of the drug and the message as a whole.
“I find the adherence is much better in real life, especially for PrEP, than in studies,” said Dr. Ray Martins, the medical director at the Whitman-Walker clinic in Washington, D.C., where approximately 170 patients are on PrEP. He said no PrEP patients at Whitman-Walker had contracted H.I.V. since the clinic started prescribing it two years ago. The iPrEx study, which led to PrEP’s approval by the F.D.A. in 2012, was a global one, and adherence was much higher in the United States than overall, especially in San Francisco, where 90 percent of tests of participants’ blood found detectable levels of Truvada eight weeks after it was prescribed.
“I’m just so surprised this is a controversy,” Dr. Martins said. “I’ve never seen anything that people have had such a negative reaction to that’s proven to work.”
