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?