“I was a teenager in the mid ’80s, just as AIDS was making headlines in the mainstream press,” Ben Patrick Johnson writes in a new essay published on HIVEqual.org. “I was part of a new group for whom sex and AIDS were linked from the get-go … For those even a year or two older than me, AIDS was something that blindsided them. It was a death sentence that attacked without warning and wiped out a broad swath of gay men.”
In July 2012, the FDA approved Truvada, also referred to as Pre-Exposure Prophylaxis (PrEP), a once-a-day antiviral drug that can prevent HIV infection. The pill contains two medicines that are also used to treat HIV. If a person takes PrEP and is exposed to HIV through sex or injection drug use, the medicines can work to keep the virus from taking hold in their body.
“Today’s approval marks an important milestone in our fight against HIV,” FDA Commissioner Margaret A. Hamburg, M.D. said at the time. “Every year, about 50,000 U.S. adults and adolescents are diagnosed with HIV infection, despite the availability of prevention methods and strategies to educate, test, and care for people living with the disease. New treatments as well as prevention methods are needed to fight the HIV epidemic in this country.”
But some folks aren’t convinced.
Earlier this year, Larry Kramer caused quite a stir when he voiced his opposition to the drug, telling an interviewer: “Anybody who voluntarily takes an antiviral every day has got to have rocks in their heads… There’s something to me cowardly about taking Truvada instead of using a condom. You’re taking a drug that is poison to you, and it has lessened your energy to fight, to get involved, to do anything.”
But Johnson doesn’t agree. In his essay, he accuses Kramer of being “hyperbolic,” using “dismissive and sometimes insulting language,” and exercising “deductive logic.”
“To me, Kramer is both wrong and off-key,” he writes. “Certainly, Kramer has never been one to mince words. But this quote begs the question of why a man so intelligent and thoughtfully educated on this issue would take such an extreme position.”
While we don’t agree or disagree with Kramer’s stance, perhaps his resistance to PrEP has less to do with being “extreme” and more to do with the fact that he witnessed countless gay men take antiviral cocktails every day not because they wanted to, but because their lives depended on it, and he saw the permanent havoc those drugs wreaked on their bodies.
According to Gilead Sciences, the company that manufactures Truvada, the new antivirals don’t have nearly the same harmful effect on the body as the old ones did, and are proven effective in reducing HIV infection, though there can be serious side effects. But considering the horrors Kramer has seen, we can sort of understand his resistance to men voluntarily taking a drug similar to the one his friends were forced to take, even if we don’t 100 percent agree with his viewpoint.
Johnson has a slightly different theory.
“I smell fear,” he writes. “I sense a distrust of new direction.”
“If there are studies or statistics that support Mr. Kramer’s claim that Truvada lessens one’s energy to fight or causes apathy, I’ve not seen them. I suspect Mr. Kramer is engaging in deductive logic that skips important steps. Fear makes us do that sort of thing.”
We can think of a lot of words that describe Larry Kramer, but “fearful” isn’t one of them. He showed tremendous bravery during the initial onslaught of the AIDS crisis, after all. Still, Johnson has a very good point. We haven’t seen any statistics that say Truvada lessens a person’s “energy to fight” either. If anything, it’s done the opposite by protecting gay men and keeping them healthy.
Johnson goes on to say that he believes the root of the PrEP debate lies in a generational gap.
“Perhaps we can chalk that up to age and the skepticism with which older, battle-wearied warriors views [sic] those who’ve taken up the charge after them,” he writes.
“The best answer for all of us, and especially for those like me who reside in the HIV/AIDS generation gap, is to try and take the caution of the past and marry it with the enthusiasm and audacity of younger activists,” he continues.
“There must be a balance,” he urges. “While keeping an awareness of PrEP’s limitations, we should promote it as loudly and widely as we are able, and work to make it accessible and affordable for as many human beings on the planet as we can.”
He ends his essay on an optimistic note: “Through a marriage of older activists’ long-sightedness and younger activists’ fearlessness, we just might bring this epidemic to its knees.”
What do you think? Is the resistance to PrEP expressed by some members of the gay community merely the result of a generational gap? Or is it more complicated than that? Let us know your thoughts in the comments feed below.