Truvada: Chill Pill or Party Drug?

A new method of HIV prevention leads to old-school sex-shaming

Would taking a pill every day make people less responsible?Credit: Jeffrey BeallDid you know that there's a pill you can take that greatly reduces your risk of contracting HIV? Chances are, unless you're in a major risk category, you probably don't.

The drug is named Truvada, created by Gilead Sciences. It has been around for years as part of the treatment regimen for those already infected with HIV. But more recently, researchers have discovered its usefulness in preventing the disease's spread as well.

In 2012, the Food and Drug Administration (FDA) approved the use of Truvada as a daily medical regimen for those without HIV looking to avoid infection. The system of using the drug as an HIV version of birth control is known as pre-exposure prophylactic, or PrEP.

The drug is a boon for anybody having unprotected sex (though Gilead encourages users to still engage in safer sex practices, and the drug doesn't protect from other types of diseases) or for anybody who is uninfected who is in a relationship with somebody who has HIV. The drug isn't cheap, costing thousands of dollars per year, but because of the FDA approval it is covered by some health plans.

The drug hasn't really taken off as a form of HIV prevention and has instead become embroiled in controversy that should seem familiar: Detractors argue that, among other things, a pill version of HIV prevention encourages irresponsible sexual behavior. Taking what appears to be a major role in opposition to Truvada is Michael Weinstein, president of the AIDS Healthcare Foundation (AHF). AHF is responsible for pushing the recently passed Los Angeles ballot initiative requiring porn actors to wear condoms.

Weinstein was out of the country and unavailable for comment, but he was quoted by the Associated Press in April criticizing the use of Truvada as a preventative drug. "If something comes along that's better than condoms, I'm all for it, but Truvada is not that," he said. "Let's be honest: It's a party drug."

Those last two words—"party drug"—symbolized and helped fuel the argument by detractors that a daily pill was an irresponsible method of preventing HIV transmission. Weinstein's characterization of the drug and its users prompted a petition to try to have him removed as president of AHF.

But this latest quote isn't anything new for AHF's opposition to Truvada. AHF had been opposing the quick FDA approval of this PReP system back in 2011. They even used to have a site devoted to criticizing the medication, called nomagicpills.org, but it no longer appears to be working.

Other HIV groups have shown much more support for the PrEP system. The CEO of the San Francisco AIDS Foundation lauded the FDA's approval in 2012, calling it "a new era in HIV prevention." The opposition to the medication has taken on a moral tone, and the Associated Press noted a negative social connotation to the drug, a gay version of "slut-shaming." One HIV counselor in San Francisco responded to the attitude toward those who take the drug by embracing it, offering T-shirts emblazoned with #TruvadaWhore.

Some of the criticisms of Truvada—that success depends on taking the pill daily, that it encourages irresponsible sexual behavior, that it may fail—seem rather strange coming from AIDS activists who want to keep condoms the primary form of infection prevention. After all, the same potential flaws can be ascribed to condoms.

Given Weinstein's campaign to force condoms onto porn actors, it's worth looking to see whether the adult film industry had considered PReP. Diane Duke, president of the Free Speech Coalition, the trade association for the adult film industry, says they were currently in discussions about whether to add Truvada's PReP system to the health protocols for actors.

"PReP has a significant amount of promise," Duke says, "not just for performers, but for everyone." As a former worker at Planned Parenthood, Duke says she sees similar judgments against those who use Truvada that she saw against women who used birth control. She argues that there's no reason to believe users of the drug would be any less responsible than anybody using any other form of prophylactic.

"For those who choose to use Truvada PReP, it will be just as well thought out as women taking birth control," she says. "Any moral judgment on somebody taking care of themselves is absurd."

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • ||

    If you can't be a slut, what good is it being gay?

  • ||

    If you can't be a slut, what good is being alive?

  • susan221||

    Start working at home with Google! Just work for few hours. I earn up to $500 per week. It's a great work at home opportunity. I can't believe how easy it was once I tried it out. Linked here www.Pow6.com

  • Thomas O.||

    By posting slutty pictures of yourself so that Google Image Search can easily pick them up?

  • Free Society||

    We should ask the conspicuously named "Warty".

  • GILMORE||

    "Gay Slut-Shaming"

    This was inevitable, wasn't it.

    ...

  • Sock Monkey||

    So this article is what, caution-shaming? Moral-judgment-shaming? Disagreement-shaming?

    Perhaps Reason could stick to reason, and forgo labeling any opposing viewpoint as "shaming."

  • Hugh Akston||

    Drink!

  • ||

    To wash down some Truvada! Hugh, you ignorant slut.

  • Hugh Akston||

    Sorry, is that a Game of Thrones reference? I don't get it.

  • ||

  • Acosmist||

    They're SJWs at heart.

  • Duke||

    Truvada. A drug that can prevent you from contracting HIV. Side effects of Truvada may include contracting HIV.

  • Loki||

    Moral busybodies need to get a life. I don't see any problem with people taking proactive steps to mitigate risks of any activities they may choose to engage in. It's not really any different than wearing a helmet when riding a motorcycle, or getting a concealed carry permit after taking a job as a delivery man who has to work in some rough parts of town. Or just carrying a piece for protection. Although some people shit their pants over that, too.

  • Christophe||

    "Although some people shit their pants over that, too."

    Bingo. Are you behaving an approved manner? That's the only thing that matters.

  • NickiEtheridgelyr||

    my neighbor's mother-in-law makes $81 /hr on the laptop . She has been laid off for six months but last month her payment was $18141 just working on the laptop for a few hours. you could look here.....
    http://www.Works23.us

  • DEATFBIRSECIA||

    Tell her about Truvada, before it's too late!

  • ||

    Truvada: the pill what brought the 'bare' back into 'bareback'.

  • ||

    So the thinking goes, if people feel more protected from the consequences of an action or set of actions they may behave differently than if they were fully exposed to the risk? Well I'll be damned. Somebody should come up with some convenient term for this theory. And then promptly propose a law outlawing insurance.

  • politicsbyothermeans||

    Wouldn't the above arguments apply to birth control? It was the same BS with the HPV vaccine, right?

  • dpbisme||

    So much for any "Reason" in this article... I am no prude but Sexually Transmitted Diseases (STD) are spread by, yes you got it, SEX, and (since I can't come up with a better term for it because I need coffee) living a "Moral Lifestyle" protects people and populations from the spread of STDs. People who believe there should be no moral judgement on people who screw around with multiple partners are clueless about how the population as a whole views this subject. I mean really, If I knew some girl I was dating had screwed four other guys in the last month, I might be a bit queasy sleeping with her. I mean really marriages are destroyed and people kill people all the time over Infidelity and sex. And some new age bozo that stands up and says,,, this is normal and please don't judge me is living in La-La-Land.

  • DEATFBIRSECIA||

    Drink again!

  • DEATFBIRSECIA||

    Oh, and you're a complete dipshit.

  • Number 2||

    "Some of the criticisms of Truvada—that success depends on taking the pill daily, that it encourages irresponsible sexual behavior, that it may fail—seem rather strange coming from AIDS activists who want to keep condoms the primary form of infection prevention. After all, the same potential flaws can be ascribed to condoms."

    And as I recall, those very arguments were made against condoms in the 1980s by those who were morally offended by Surgeon General C. Everett Koop's suggestion that condom use was the best way to prevent the spread of AIDS, and by the efforts of AIDS activists to encourage condom use. Thus heightening the irony.

  • OrangeCouch||

    If you are the type that is so concerned about contracting HIV that you seek out and purchase a pill to prevent it, aren't you also MORE likely to use a condom?

    And there's no need for trying to parallel this with condom usage - use a car analogy:

    Based on the Weinstein's reasoning, people who wear seatbelts are more likely to crash their cars. Hence, we should outlaw seatbelts to prevent accidents...

  • Edwin||

    //After all, the same potential flaws can be ascribed to condoms.

    Are you fucking kidding me? Are you really going to compare a 100% material barrier to fluid transfer to some drug that only MAY prevent the spread of HIV while doing normal sex where there's a shit ton of fluid transfer? Truvada is obviously way more risky

    the drug sounds stupid anyway. Presumably you take it to prevent HIV and have unprotected sex, but if you keep having uprotected sex you will eventually get HIV. The only way that this could help is if you half-slut it, like, you only sleep with one or a few other people and not super often and you get tested and ask them about new partners and stuff. Is that even a thing though? a half-slut? Anybody actually do that? And even assuming that would help, it still involves actual lifestyle and planning changes, not just the damned drug. Might as well just practice the lifestyle changes w/condoms

  • Mark22||

    HIV negative people are in relationships with HIV positive people, so this doesn't just affect sluts and half-sluts.

    I think it's a reasonable second-line defense should condoms and other preventative measures fail, as they do occasionally.

    However, I don't see why this should be covered by health plans. I think it's reasonable to expect people to pay for this themselves.

  • Mark22||

    I'd have less of a problem with it if people had to pay for it themselves. I don't see that others should pay for something that is clearly an individual choice (but, then, I feel the same way about obesity and smoking-related disease).

    There is also a public health concern: widespread reliance on these drugs may encourage the spread of resistant viruses. From a public health point of view, safer sex is a better choice.

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