In 2012, the Food and Drug Administration approved Truvada, a drug used to treat HIV by making it more difficult for the virus to multiply, as a preventative against infection. Since then, there has been a significant debate over who should be taking the drug, with the majority of the discussion centering around gay men. Unfortunately, there have been serious social stigmas against use of the drug — members of the gay community have said they felt ashamed for taking it. But this is not an issue solely for gay men. About 48 percent of those prescribed Truvada are women, as the drug is commonly given to HIV negative individuals in a relationship with someone who is HIV positive.
In a surprising turn of events, the president of the AIDS Healthcare Foundation, Michael Weinstein, legitimized this stigma by calling Truvada a “party drug” because of its potential to discourage condom use. There are plenty of legitimate concerns with Truvada, but it is irresponsible for the president of the largest global non-profit fighting HIV/AIDS to only partially address them in such an insensitive manner. Truvada has been shown to reduce the risk of acquiring the HIV-1 virus by 90 percent when used properly. Preventing infection requires a daily dose of the pill, and one study showed only 10 percent of users took as directed. Both of these factors necessitate the additional use of condoms and increase the risk of the emergence of drug resistant strains of HIV, but labeling the breakthrough medication a “party drug” will discourage potential users from educating themselves on proper usage.
Truvada carries a warning against preventative prescription to those who are HIV positive because of concerns with drug resistance, issues with adherence and failure to wear condoms lead to a greater potential for drug resistant strains as the virus can mutate in the presence of the drug. Given how far we are from a cure for HIV, the potential emergence and spread of drug-resistant strains must be a premier concern. Ideally, Truvada should be viewed as a safeguard when condoms fail.
Weinstein should focus his critiques of Truvada on its scientific pitfalls instead of insulting those prescribed to it. In the past, Weinstein has been far more eloquent in his criticisms of Truvada. He addressed the concerns with adherence and its somewhat contentious success rate, saying “it’s just not ready for prime time as a public health strategy.” His recent statement may just express frustration with increasing acceptance of Truvada and reports of declining condom use, but it is still unacceptable for the head of the AHF to express such derisive opinions. There is currently a petition on change.org calling for Weinstein’s resignation. By likening Truvada users to illicit substance users, Weinstein is harming the progress his own organization has made in fighting the stigma associated with HIV.
A version of this article appeared in the Tuesday, April 22 print edition. Tess Woosley is a staff columnist. Scientific Society is published every Tuesday. Email her at [email protected]