A NEW ERA?

“HIV’s Sexual Revolution” Begins As Researchers Test Three-Month Truvada Vaccine

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Truvada advocate Michael Lucas, right, with Sean Xavier

The New York Times published an op-ed piece this week hailing the controversial “HIV-preventing miracle drug” Truvada as a new “sexual revolution” for the gay male community, likening it to the invention of birth control and wondering if it has the power to lower the “viral load of a city.”

Plagues and pestilences reporter Donald G. McNeil argues that the FDA-approved daily pill could work to eradicate HIV altogether if more people were on board with it:

For now, Truvada has no Andromeda or Margaret Sanger. The C.D.C. recommendations were released quietly, with no news conference. And Gilead Sciences, its maker, doesn’t advertise it for PrEP.

But it may yet become accepted. If it does, it will become part of a larger truth emerging in the field of AIDS medicine: Modern antiretroviral drugs are phenomenally potent weapons. They could be the key to finally shrinking the epidemic.

Truvada critics claim it’s unethical to force otherwise healthy people into a daily pill-popping preventative regimen, and many believe that the drug’s success rate isn’t significant enough.

Science is working on it, McNeil says. Surveys suggest that many potential Truvada users would be more likely to receive a three-month Truvada shot over daily pills, if such a thing were available:

Protection of 96 to 100 percent is better than even the best vaccines. But vaccines protect for life while pills must be taken daily.

Some women found that hard with the Pill, so the contraceptive market eventually developed long-lasting injections, implants, vaginal rings and “morning after” pills.

The H.I.V. field is already moving that way.

A recent survey of 200 young gay men conducted by Perry N. Halkitis, a behavioral researcher at New York University, found that if a three-month Truvada shot existed, 79 percent of them would prefer it over daily pills. Two studies in monkeys have already tested the long-lasting injectable concept, and it worked.

The new drugs permit even grander ambitions. By treating enough inhabitants, the whole “viral load” of a city can be lowered. That protects everyone — just as cities used to slow down smallpox outbreaks by rapidly vaccinating thousands of inhabitants.

Is “HIV’s Sexual Revolution” on the horizon?

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42 Comments

  • Jeton Ademaj

    of course it is, it’s already underway. unfortunate but understandable that public comprehension of science lags behind scientists.

    there is now a wide spectrum of HIV prevention tools one can use, including or not including condoms. personally i look forward to a renewed sense of engineering artistry and real-world utility in the design of next-generation condoms…that spray-on nanoparticle condom sounds fascinating in concept!

    as Queers we need to understand the science better than most of the public, because HIV is especially threatening to us.

  • Qjersey

    No one wants to seem to talk about the cost of Truvada.

    The patents for Truvada will begin to expire in 2017, but Truvada was made available as generic in “developing nations” in 2013…just before Gilead started pushing PrEP.

    Truvada costs about $40 per pill or $1200 a month.

    Gilead also has a wonderful program to cover the insurance co-pays if you can’t (which they write off as charity after charging so much for the pill…charming). Co-pay on my insurance is $300.

    I bet the new shot becomes available just as Truvada goes generic….and I’m sure this single shot will cost well over a 1000 bucks.

  • Ben Dover

    Apt comparison with contraceptives!

    Cue the comments from those superior gay men who are (supposedly) outraged at the cost.

    They’ll sound so much like Rush Limbaugh calling Sandra Fluke a “slut.”

  • michael mellor

    I want to use Travada. I like to be a sex pig. After all, I’m a male.

  • michael mellor

    I want to live my whole life in steam-rooms. There, I will open up my insides to complete strangers with various illnesses. I know that I can do this because I will have Truvada watching over me 24/7. Truvada is truly trustworthy.

  • jonjct

    ^ O M G

  • ingyaom

    I would say the stakes are a little higher for gay men than hetero women. Without birth-control, a woman might become pregnant; while a man having unprotected gay sex could get HIV… which could lead to AIDS and death.

  • Stache99

    @TheNewEnergyDude: I agree but he’s been deleted before under other aliases. Jimbryant to name a few. He’ll just find another way to get back on.

  • Stache99

    Interesting and good comparison to the birth control pill. Costs and health concerns. Just like the pill the state should help cover the cost for those that can’t afford it.

  • redcarpet

    @Qjersey: You must have really really terrible insurance. I have a cheap group plan that my company offers (no other choice per the ACA) and my copay is only 40 bucks a month, and I think Gilead will reimburse.

    I’m going to hold off till the dust settles though. It still seems so new, and I’m not sexually active right now and I don’t intend to be for a little while.

  • Mikelog

    Did I missed something?? Does Truvada protects from a slew of STIs? The pill should be subsidize, but I hope people don’t become reckless just because they have another tool against HIV. Most STIs aren’t your common cold…

  • Stache99

    @Mikelog: Do Birth Control Pills?

  • michael mellor

    Imgyaomp,

    There is no such thing as gay sex. There is vaginal sex (true sex) and there is anal sex (faux sex). Neither type will lead to an STD if both partners in the act of sex are healthy. Two healthy people engaging in sex with each other cannot catch an STD from each other.

  • Mikelog

    @Stache99: In the case of birth control we’re talking about a revolution because women are not limited or exploited because of pregnancies. In other words not constrained by their sex, and the facilitation of female agency, hence the idea of a sexual revolution. Women still had sex before, that’s not what the sexual revolution is about. HIV still falls under a spectrum of STIs, so there is a revolution in treatment and prevention of HIV, but I still fail to see how this can be considered a sexual revolution. Maybe I’m looking at this the wrong way or missing something.

  • michael mellor

    Mijelog,

    Actually, contraception has facilitated female prostitution. It has turned women into extreme sellers. Contraception is not natural.

  • Ben Dover

    @michael mellor:
    Jim – At last, the Chinese do something right! The toxins in that blow-up doll they sold you are destroying what’s left of your brain!

  • Ihadtosayit

    PrEP, short for pre-exposure prophylaxis, is a relatively new HIV prevention strategy in which an HIV-negative person takes a daily pill to reduce the risk for HIV infection.

    PrEP has made headlines recently—and the messages haven’t always been clear. Watch this video to get the facts about how PrEP works and see three PrEP myths busted.

    https://www.youtube.com/watch?v=-Xx92whZS0o

  • peter

    i am on tenofovir right now because i have hepatitis b. my docotor says i do not have any liver damage it was just a “chronic inflamation” my last test says i am undetectable with the hepatitis b. i read on the internet that you can take tenofovir as this prep medicine is this true? i was tested 2 years ago for hiv and i am not poz and i have not had sex since then because i am too afraid to catch anything else and i do not want to spread the hepatitis. i was wondering if anyone knows that just tenofovir is enough as a prep medicine? i am not really out to my doctor so do not feel comfotable asking him.

  • Ihadtosayit

    @peter: YES it is…PrEP involves having an uninfected person take ARV drugs—usually Truvada (tenofovir plus emtricitabine)—before, during and after possible high-risk exposures to reduce the risk of becoming infected with HIV.

    http://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf

    Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

    http://www.aidsmeds.com/articles/HIVtests_12371.shtml

  • peter

    @Ihadtosayit: i read this and it really only talks about the emtricitabine along with the tenofovir…but you are saying that even though its not officially approved its probably ok? its not like i am going to have sex soon, i’m still too afraid . i always used condoms so that kinda saved me if i had by chance had sex with an hiv guy because i did test neg two years ago. if i decided to have sex i would still use a rubber even still being on this drug

  • Stache99

    @peter: Not to discount anything your saying but why do you keep changing names. Is is Peter or Joey?

  • michael mellor

    Cancer is a risk. Heart attack is a risk. HIV is self-inflicted.

  • Ihadtosayit

    @peter: You need to have a frank conversation with a doctor and/or HIV health care provider…I do not want to declare that I am a professional in these matters…all my best

  • Ihadtosayit

    @michael mellor: Yes you are correct: cancer is a risk and heart attack is a risk…writing on these message boards while being an asshole is self-inflicting…just as you are spouting that others can avoid HIV…can you avoid being a “judgmental small minded I want to have all the focus on me self-asborbed person” …that is something you will have to answer but trust me when I say your answer will take longer than a cure all the diseases that you have mentioned and you will simply die with it…

    https://www.youtube.com/watch?v=fQbRyay_ojY

  • Teeth

    @michael mellor: Cancer is a risk: mediated by lifestyle. Heart disease is a risk: mediated by lifestyle. We are so quick to attack ourselves around this issue- and I get it; we’ve been told that we’re going to hell and ruining the world all our lives. But the behavior associated with HIV risk is no more immoral than the behavior of being even 10% overweight, or smoking, or driving fast, or living in a city, etc.

  • peter

    @Stache99: duh i dunno…i just noticed that. sometimes i use my iPad and sign in there ..i think i opened an accout using my iPad. one is my real name the other is not..i try not to use my real names for on line stuff..sorry my bad

  • misterhollywood

    Interesting post and I will be sure to follow this story. Thanks for sharing Queerty!

  • erikwm

    I have read that Kaiser Permanente — the largest health care provider in the United States — does not want to cover Truvada for PrEP, that their doctors discourage those who seek it for preventative purposes. I am not sure if this is true. I have Kaiser and just assume it wouldn’t be covered. ED medications are not covered under my plan, either.

    Besides the cost, I’m also uncomfortable with the potential side effects and am not sure if i’m willing to place such a high level of trust in a medication.

  • michael mellor

    HIV is a choice. Don’t deny it.

  • Teeth

    Diabetes is a choice.
    Living in a city with a crime problem is a choice.
    Not exercising is a choice.

  • toberlin

    to michael mellor vrs.Teeth:
    HIV is a Virus not a “Choice”!

    and there a a lot of different types of Diabetes and there is always a genetic/polygenetic cause as well or just a genetic cause.

  • toberlin

    no comment to the HIV=Pregnancy discussion.
    In Germany Travada is just a approved medical treatment for HIV-Positive people now.As far as I know there are more medical than ethical concerns.
    I don’t think Truvada for HIV-Prevention is “unethical”and nobody “force”people to take a Pill every Day.People are different .I think this is one more way to prevent a HIV-Infection.

  • iGav

    As much as it’s tempting to hope that a prevention for the spread of HIV might be on the horizon, I would urge caution int the minds of those people that think the Prep is an alternative to safe sex. HIV is one of many potentially life threatening sexually transmitted diseases, and pill popping is never an alternative to understanding and minimising risky behavious.

    Does it hold the hope that we might see this spectre brought under control, yes, but let’s not be fooled by that into complacent behavious.

  • toberlin

    It is so absurd to me that Nations have no problem to spent millions for drugs and pills but better SEXUAL EDUCATION for ALL Children /Teenager is a Problem.Not to talk about Sex never kept people away from having Sex.
    It makes me so angry that everybody knows about the high HIV-Stats among MSM and Boys still get not better/more Education in Schools.

  • Ben Dover

    @michael mellor: Cancer CAN be a choice: 40% of gay men are smokers (compared to only 18% of straight men) and that’s disgusting and gross! As well as being a choice.

  • Teeth

    Yes to some forms of cancer, diabetes, and other things being not a choice– my point is not to beat people up, but to stop being so negative and biased against gay men. LOTS of people do lots of stupid things that cost us money and pain. We should work on the behaviors.. but blaming one group of people and even considering refusing treatment for them alone is the most tangible discrimination of all. We don’t refuse to fund treatment for other preventable diseases.

    There have been several studies already, though more is needed, showing that men on PreP do NOT change their sexual behavior. They don’t get wild all of the sudden. I know it’s a fear that people have, but it’s not based on fact but on stereotypes. If you think differently, design a study and get it done- otherwise, it’s a stfu moment.

  • toberlin

    @Teeth:We have anyway another Health Care System in Germany.Our HIV-Stats are much lower than in the USA.The approval of Drugs in Europe/Germany is often different/longer Process than in the USA.This is not HIV specific.
    I read this Studies too.And like I said People should have a Choice in HIV-Prevention or Sexlive.I am no ones Nanny.

  • Teeth

    @toberlin: I agree– it’s too much to expect that I can supervise my neighbor’s personal life. I do think, however, that your emphasis on education is not on target. I don’t think anyone here fails to know what HIV is or how you get it. It’s a much more serious problem of our culture being so homophobic that little gay boys don’t grow up with the self respect to maintain their health.

  • Geeker

    There’s just too many other more and more dangerous STDs out there for the gay community to rely on a pill alone,we still need to use condoms or risk creating something even worse that there is no treatment for at all.

  • Teeth

    @Geeker: Which one? Which STD is more dangerous than HIV?

    As a general rule, total wild abandon hedonism is a perfect laboratory for creating new and exciting diseases– so maybe that is what you mean. I don’t think condoms are an adequate answer, however. In fact, I know it. I see it in how unsatisfying most people find condom sex. Even condom porn wont sell anymore. We need healthy lives that include sex, and we have not figured out exactly how to get there yet. Rather than being judgemental about someone who go caught up, think we should work toward that end. Human history is FULL of people screwing who they aren’t supposed to screw– it’s part of what we are.

  • Ihadtosayit

    @Teeth:

    The CDC estimates over 19 million new STD infections are diagnosed every year in the U.S., almost half of them in men and women 15 to 24 years old. Doctors say there anywhere from 25-50 different kinds of STD, though you have probably only heard of the 7-10 most common ones.

    Most sexually transmitted infections are not deadly, and many are just inconvenient. Many people live their whole lives with an STD—but this doesn’t mean you should just “wait until it goes away” if you think you might have one. No one wants to go to the doctor for problems down there, but STDs can cause anything from the downright disgusting to pain, infertility, and death. Here are the top 10 most common STDs, arranged in order from most common to least common in the U.S.

    http://akorra.com/2011/11/01/top-10-dangerous-sexually-transmitted-diseases-stds/

  • barkomatic

    It’s almost as if some us are disappointed at the prospect that PrEP could wipe out HIV. It seems they think that catching HIV should be the appropriate consequence of having what they consider to be immoral or irresponsible behavior. No one with any sense should avoid Truvada because they think they’ll be judged.

Comments are closed.