The Truvada Equation


Recommendations by the World Health Organisation that gay men should take HIV-preventative medication has gay protesters up in arms. But are they complaining about the right thing, asks Rob Buchanan?


There has been outcry from some gay rights activists over recommendations made by the World Health Organisation (WHO) that men who have sex with men (MSM) should use antiretroviral drugs as part of the fight against the spreading of HIV.

The type of medication they are referring to is Pre-exposure prophylaxis (PrEP), marketed under the brand name Truvada. Some commentators feel the announcement reinforces the tired, demonstrably false stigma that HIV/Aids is a ‘gay disease’. I think those activists would have better directed their energy by not immediately playing the insulted victim card and instead pointing out that PrEP can help in the global fight against Aids, that heterosexual people can benefit from the drug too. At the same time, activists should be using the PrEp platform to talk about safe sex and responsible testing.

WHO is not saying all gay men have HIV or are likely to contract the virus. Their recommendations were that doctors should offer patients with HIV the drugs once their CD4 count has fallen below 500. What’s more, the research presented in their guidelines estimates such an initiative could prevent three million deaths by 2025.

The fact is that antiretroviral drug use can reduce the chance of passing on HIV by up to 92%. PrEP not only protects against the transmission of HIV, it also helps to stem other diseases such as herpes. But it is not a magic bullet, and neither is it a license to bareback indiscriminately.

The great irony in what’s been happening since the WHO recommendations came out is that those protesters falling over themselves with political correctness towards the gays are actively participating in endangering the lives of people they seek to speak up for. A balance needs to be struck between the gay ghettoisation of the virus and addressing statistics that show a rapidly rising level of gay men are being infected, particularly in younger generations. PC platitudes and righteous indignation are not going to protect those men, no matter how well intentioned it all is.

The recent spike in gay HIV infection shows a shocking complacency about safe sex, possibly due to recent advances in medication that make the HIV virus no longer a death sentence. There is a new education defecit that has lulled some queers into underestimating the risks of irresponsible behaviour.

Perceptions of the virus have huge repercussions for everyone on the planet. If the prevention message is too heavily loaded towards gay men, then heterosexuals may begin to feel they are somehow immune to it. With this in mind, I can understand where the WHO protesters are coming from.

Most gay men know the feeling of sitting in straight company when the issue of Aids comes up, be it on TV or on the news. An elephant takes up residence in the room. No matter what has happened in the world since the 1980s, with the epidemic spreading like wildfire through certain populations, there is still the subconscious belief that Aids is a gay disease.

Still, we are not dealing with an issue of prejudice as much as we are a deadly global pandemic. The greatest weapons against aren’t spin or marketing. They’re the same as they’ve always been – education and safe sex.

When it comes to the big, life or death issues affecting LGBT people, it’s useful to step back occasionally and see what the larger ecology is. Would it be better to address a global problem (be it a social, political, or medical) on a general level, transcending sexual orientation? I believe with a massive enemy like HIV/Aids that a broader approach is essential. The virus doesn’t discriminate, neither should we.

© 2014 GCN (Gay Community News). All rights reserved.

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