Michael Weinstein Doesn't Like It, But He Still Shouldn't Fear Monger over PrEP
Seems Michael Weinstein, leader of the AIDS Healthcare Foundation, has a great dislike of PrEP (Pre-Exposure Prophylaxis). Weinstein has been making headlines for calling PrEP a "party drug," but this hardly his first foray into the debate on the use of the anti-HIV drug Truvada to prevent new HIV infections.
Even before the FDA approved Truvada for PrEP in July 2012, Weinstein and his organization were assaulting the intervention. In an October 2011 press statement encouraging people to sign a petition to Gilead, makers of Truvada, the AHF folks opined:
PrEP may lead people currently using condoms — which are far more than 44% effective in stopping HIV— to quit using them. Those who contract the virus while on PrEP run the risk of developing drug resistance before finding out they are positive, and spreading that drug-resistant virus to others. Paying for PrEP would also likely take away funds from less costly and more effective HIV prevention methods.
Oh the problems with this statement...
When taken daily, PrEP is upwards of 100 percent effective. Yes, that's right, when people use PrEP correctly, it is nearly 100 percent effective. But when they don't, they are no more effective than rolling the dice. Funny, the same is true of condoms — with the exception of efficacy in use.
AIDSMap reported on a study released at the Conference on Retroviruses and Opportunistic Infections (CROI) in 2013 reported that condoms, used consistently in anal sex are only 70 percent effective in reducing new infections. While on again and off again condom use reduces the protective effect of condom use to the same probabilities as rolling the dice -- you know like not taking PrEP daily does.
Incidentally, that CROI study also found that only one in sex were using condoms everytime, and other studies have found condom use is about 50 percent. Clearly, universal adoption of condoms is a mythology that Weinstein and company would prefer to keep alive.
It is also important to note that PrEP was received FDA approval as an intervention. Thirty years into the epidemic, we are still waiting for a condom company to submit a latex or other synthetic product condom for approval for use in anal sex. You read that right, the FDA has never approved any condom for use as a medical device in anal sex.
And that fear of tossing condoms out the window to fornicate wantonly now that a pill is available? Yeah, fear mongering at its best. A December 2013 study released on PLOS reported: "There is no evidence of sexual risk compensation in iPrEx." iPrEx is the study that proved PrEP was an effective prevention intervention.
So, let's cut the crap from Mikey. He doesn't like PrEP and it's got nothing to do with efficacy or increased risks to people on the drug. No, this is about Mikey pontificating with ill-informed opinions and trying to scare the hell out of men who have sex with men.
This is, afterall, the same organization that put a float in the 125th annual Rose Bowl Parade to "celebrate same-sex marriage and the role it can play in helping to reduce new HIV infections." Of course, they completely ignored the Office National AIDS Policy employee Gregory Millett's presentation from 2012 at the National Gay and Lesbian Creating Change Conference in Atlanta. There, Millett noted that 68 percent of new infections are happening in the context of primary sexual relationships — you know, in the context of boyfriend and husband relationships.
But why in the world would Mikey let the world know his thinking is based on proven falsehoods?