Truvada: The HIV prevention pill no one is talking about

Max Cameron and Andy Clements have been dating for more than a year. Max works in special education, and Andy, a chef.

“I’m not a very big believer of love at first sight. But, when I saw him, I was like ‘whoa’” Max told us.

The two are living the dream in San Francisco, but they are not like every other couple, they are in a serodiscordant relationship. Max is HIV-negative, and Andy is HIV-positive.

“I just recently told my mom that Andy was HIV positive. And she was like ‘Oh my god.’ She is obviously concerned about my safety, my health, and my well-being. So, naturally as a mother she was really worried about me dating someone who is HIV positive,” Max explained.

Andy has been living with HIV for the past 14 years. During our interview, Max started tearing up when we asked him about the stigma he and his boyfriend face.

“You’d said something – you said ‘I hate being treated like a leper, and, it kind of broke my heart.’”

It wasn’t until a few months after they started dating that Max discovered a medication that would change their lives.

“I first heard about the HIV prevention pill from a friend of ours. I asked ‘What is this all about?’ Are there side effects? Tell me about it.’”

Truvada is an antiretroviral medication prescribed to people who are HIV-positive. But when the little blue pill is separated from the pack – and taken by someone who’s HIV-negative – it lowers the changes of contracting the virus. The therapy is also known as Pre-Exposure Prophylaxis or PrEP.

“The pill has definitely helped us become more intimate,” Max explains.

There’s another reason Max takes Truvada. He’s a gay adult film actor, and he participates in porn that’s condomless. His costars include both HIV-negative and positive actors. We spoke to his coworkers during a shoot and asked if guilt was a factor when having sex with someone who’s negative. Max’s HIV-positive costar Christian Matthews told us, “I disclose my status 100-percent to the studios and to all the people I work with. There’s no hidden agenda.”

“I always put my status out there, so the other person can decide if they want to go through with it,” another performer Kory Mitchell said.

This pill may sound good to good to be true. So — how effective is it, and how does it work? We met up with Dr. Robert Grant while we were in San Francisco. He performed the first trials on the medication before the FDA gave their stamp of approval in July 2012.

“The HIV prevention pill works by blocking the HIV virus growth inside cells, so the virus can get into the body, but it doesn’t spread,” Dr. Grant explained.

In the initial studies of the drug, it had a 42% success rate, but later tests have shown that daily use of the medication provides 99% protection. According to the Centers for Disease Control and Prevention, there are about 50,000 new HIV infections every year in the U.S. But since 2013, only 1,400 people have started taking Truvada as a preventive measure.

“The manufacturer of this drug decided not to advertise this drug in the marketplace, and that decision was based on controversies of people accusing them promoting prep and causing people to take risks in their lives. They decided not to advertise prep,” Dr. Grant said.

We reached out to Gilead – the manufacturer of Truvada – to ask about their decision not to market the drug. In a statement provided, they wrote:

It is true that we do not have any immediate plans to initiate a marketing or advertising campaign. Instead, we are focusing our efforts on education initiatives designed to reach healthcare providers, community organizations, and individuals who may benefit from this intervention.

As a result, many people at-risk haven’t heard about this pill. Doctors have also been left out of the loop. The AIDs Healthcare Foundation is speaking out against the drug.

The group’s president Michael Weinstein has called Truvada a “party drug.” He says that the pill will just give men another excuse to “not use condoms.” And, he claims this will cause a “catastrophe with HIV prevention.”

With the back-and-forth over this pill, there’s an obvious correlation between medication and sexual liberty.

“There’s striking parallel between the birth control pill and PrEP,” Dr. Grant said. “The birth control pill was invented in 1959 but really didn’t take off until the 70’s As late as 1967, there was a case of a physician at a major university who was fired because it was discovered that he was prescribing birth control pills to unmarried women. It takes a while to get used to new ideas – especially when it comes to sexuality.”

To add more fuel to the fire, the CDC has also reported that unprotected anal sex between men is on the rise – jumping almost 20% between 2005 and 2011.

“I can’t speak for all gay men but generally gay men like to go out and have some drinks and let our guard down and sometimes we’ll do things we may regret the next morning when we wake up and sometimes you will have unprotected sex sometimes because you got drunk one night. And I think it’s still important to take responsibility for yourself,” Max said.

This pill may not be for everyone but it’s undeniable that despite its controversy, a new weapon exists in the fight against HIV.

Credit: Lauren Santa Cruz and Mitchell Williams

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