Towards the end of each year, I write a series of posts about the biggest LGBTQ stories. This year, I’m writing about the five stories which shaped the LGBTQ community in 2015.
HIV/AIDS has again become a common story in 2015, maybe for the first time since the epidemic was at its worse. This is due to two reasons: 1) new infections of HIV/AIDS is increasing for men who have sex with men and 2) A new prevention strategy is on the rise centering on the use of PrEP, a daily dose of the drug, Truvada, taken as a prophylactic therapy. I wrote about HIV/AIDS 17 times during the past year, and about PrEP specifically four times. With organizations which focus on HIV/AIDS increasing their emphasis on PrEP, it will become a growing story in 2016 as well.
PrEP shows great promise to help curb the spread of HIV, which is essential to end the epidemic that continues to decimate women and men around the globe. But this value is coupled to problems with PrEP. It isn’t a perfect answer to the threat of HIV. But it is the first approach that shows real promise and for no other reason, it deserves more attention.
The research surrounding PrEP is conclusive when it comes to use of PrEP by couples where one partner is poz and one is neg. But the gay male community is most interested in use more generally as a replacement for having to use condoms as a prevention of HIV.
One of the real values of getting as many men on PrEP as possible is that it addresses the biggest cause for new infections. Most new infections are caused because a person doesn’t realize they are HIV pop, and spread the virus through unprotected sex. PrEP means that regardless if a partner is unaware of their status, a person is protected.
The problems I have with PrEP are several.
End the debate
As the graphic shown displays, promoters of the use of PrEP are generally not interested in any debate or discourse. In my opinion, this is a huge mistake. PrEP has such value, yet the use must be combined with adequate dialogue if it is going to be truly successful. The community has to be free to talk about what it will and won’t do, and why.
PrEP by itself is untested
In every research study, the use of PrEP is combined with regular counseling about safer sex practices and condoms. No study has explored how much of the success seen with PrEP can be attributed to this ongoing counseling and emphasis on using condoms. To admit this doesn’t take anything away from the overall success, but it can be a real determining factor if we are to see success in more general use.
PrEP use must be constant
For PrEP to be useful, it must be taken everyday without fail, and research shows that this is a potential problem. Most everyone can take a daily pill for a while, but maintaining that routine is hard to keep up 100%
Looking forward, PrEP is likely to evolve in ways that address these problems. Already, research has shown that PrEP taken for the few days before a sexual encounter and a day after can be as effective as an every day regimen. New delivery strategies will allow Truvada as well as other drugs to be used in more efficacious ways. Because of this, 2016 could truly be a turning point in the fight against HIV/AIDS.