Truvada Takes Hold as an Urban HIV Prevention Tool
Big city health departments working on making it more available to those at risk.


It's been a little more than a year since we made note of the slow growth in the use and debate surrounding Truvada, a drug cocktail originally designed to help treat HIV-positive people that has also turned out to be very good at preventing the spread of HIV to others.
Since that time the drug treatment, where HIV-negative patients take it to inhibit the transmission of HIV to them, has received much more attention and analysis. Yesterday, Los Angeles County voted to embrace Truvada's treatment method and work to make its pre-exposure prophylaxis system (known as PrEP) available to needy, high-risk county residents, joining similar efforts in other big cities like New York and Chicago. From Abby Sewell at the Los Angeles Times:
Supervisor Sheila Kuehl, who proposed the plan, said that "together with other HIV prevention tools, it'll make it possible for us to dramatically reduce new HIV infections."
"PrEP is not a silver bullet, it's not a panacea, but it is another tool that we need to offer our county residents who are at high risk of contracting HIV," Kuehl said.
Officials said nearly 60,000 people are living with HIV in the county, and about 1,850 more become infected each year. Many of them are low-income gay and bisexual men of color.
The supervisors directed the public health department to come back in 30 days with a plan to reach out to high-risk populations and disseminate the drug.
PrEP may not technically be a silver bullet, but ongoing testing has been showing it to be remarkably effective in preventing the spread of HIV. The latest research has the drug cocktail achieving peak effectiveness after just five to seven days/doses, meaning a 98-99 percent risk reduction, and it remained highly effective for days after test participants stopped taking it.
What is not as well known is what Michael Weinstein of the L.A.-based AIDS Healthcare Foundation is going to do. Weinstein has been a vocal critic of the development of Truvada as an HIV prevention system, dismissing it as a "party drug," and alienating all sorts of people over his response. He's also the man responsible for pushing the laws demanding condoms on porn actors.
Weinstein has been having all sorts of legal battles with the county based on the contracting process and his organization's participation in various county-organized health programs. A county audit declared his foundation had overcharged charged them $1.7 million for services. He claims it's all retaliation for his criticism. He has said he wouldn't attempt to block distribution of Truvada in L.A. County as long as they go through the typical bidding process, which activists fear could drag the whole process out for years. Adolfo Flores of BuzzFeed documents the troubled relationship between Weinstein and the county here.
Vice just recently put together a three-part video report on the impact of the development of Truvada on sex practices within the gay male community. Watch here (autoplay warning).
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Weinstein has been having all sorts of legal battles with the county based on the contracting process and his organization's participation in various county-organized health programs. A county audit declared his foundation had overcharged charged them $1.7 million for services. He claims it's all retaliation for his criticism. He has said he wouldn't attempt to block distribution of Truvada in L.A. County as long as they go through the typical bidding process, which activists fear could drag the whole process out for years.
We can't get rid of HIV/AIDS, there's too much money in it.
"At risk" is the same population group that's unlikely to take a preventative pill.
I'm thinking that's mostly homeless people and drug addicts, right?
Prostitutes/escorts/masseuses would probably jump at the chance for this pill. If you could kill those folks as transmission vectors a lot of good could be done.
If you could kill those folks
Oh boy.
Yeah, I thought about changing the wording, but then I remembered I'm a young, white, cute, disabled, female who looks good in blue sundresses. They try and come after me and I'm flashing my sympathy cards all over the nightly news. I'm a protected class, I'm more equal than the rest of ya'll.
Pics?
Cash up front.
Ah... Very smart.
I'm flashing my sympathy cards all over the nightly news
You want the FCC coming after you too? Best stick to HBO.
"If you could kill those folks as transmission vectors a lot of good could be done."
With a woodchipper? Or maybe you would like to just take them out back and shoot them?
This seems like a great drug for a charity to hand out to prostitutes and druggies. Especially if they nabbed a generic version. If you targeted the right people you might essentially kill HIV/AIDS in the underclass.
Uh, prostitutes are by and large are not a major vector of venereal diseases. See Maggie MacNeill. VD is mostly spread by the "good, clean" amateurs that don't take protective measures.
No afternoon lynx yet? Was it a casualty of the war we're not allowed to discuss?
When Virginia Postrel something something something.
Reason needs to find a way to keep account information in a location they can't access without warning their commenters. Something pre-programmed that the fed couldn't pressure them into disabling without letting everyone know what the feds doing.
Maybe they could rent space on Hillary's servers in exchange for a generous donation to the Clinton Foundation.
So like, take Reason out of the equation when divulging users' information? Like Lavabit. Oh wait...
If we get rid of HIV and Jesse gets to experience the joy of condomless sex, I'm gonna be fucking pissed.
Nope!
It would be a really hilarious and ironic if Attorney Weisenstein were to choke to death on a condom.
Metaphorically speaking, I would find it very entertaining if Attorney Weisenstein were to choke to death on a condom that was blocking his airway purely due to an unfortunate accident and not due to any human agency; Attorney Weisenstein being a horrible political figure on whom I am entitled to comment, purely as hyperbole, on a matter of public concern under my First Amendment rights to free speech and to petition the Government for redress of grievances.
N.B. This comment is uncontaminated by any references to wood-chippers.
He has said he wouldn't attempt to block distribution of Truvada in L.A. County as long as they go through the typical bidding process, which activists fear could drag the whole process out for years.
No price is too great for the people of L.A. county to pay in order to ensure that gays get their free medication and can once again enjoy the pleasures of unprotected butt sex.
Much better to deal with it the way Atlanta does, AMIRITE?
Is this a butt sex v. Bastiat showdown?
Really?
Eh, it's been a really slow commenting day. I'm bored and trying to start shit.
Much better to deal with it the way Atlanta does, AMIRITE?
I don't know how Atlanta deals with it. I would keep the the FDA in a strictly advisory capacity. They would only test and "give a seal of approval" but have no authority to regulate drugs or prevent any from coming to the market. People should be able to purchase and ingest any medication they want. However, I shouldn't be forced to pay for it. They have alternatives if they can not afford the medication. If one engages in risky behavior one should be prepared to accept the consequences.
Healthcare in Atlanta (both public and private) has been bad about HIV testing, treatment and prevention.
I largely agree with your view on healthcare, but I do think it misses the fact that it's essentially the norm in American healthcare now for risky behavior to be subsidized by either your tax dollars or your insurance premiums, whether that be smoking, getting pregnant, or whatever.
Insofar as a rigorous prevention a program seems to be less of a drain on taxpayer dollars for the average individual, and also means fewer individuals need care overall, I prefer it to the other options. Had we a system where medication costs weren't driven by pharmaceuticals and the government colluding to make them impossibly expensive, we'd be having a different conversation. For what it's worth I'm also hugely in favor of cheap OTC birth control, the price of which is wildly inflated by being prescription.
What is not as well known is what Michael Weinstein of the L.A.-based AIDS Healthcare Foundation is going to do. Weinstein has been a vocal critic of the development of Truvada as an HIV prevention system, dismissing it as a "party drug," and alienating all sorts of people over his response.
This dude sounds like a real piece of work.
*none of the above comment should be construed as a threat, or a threat about places in hell, or even special places in hell*
I do not own, nor do I plan to own a woodchipper in the next 72 hours.
OMG 701 ON THE PILLS!!1111!!11!111!111!!!
LIGHT THE JESSE WALKER BEACON1!!111!!11!