In a week that saw the premiere of Ryan Murphy's The Normal Heart, based on Larry Kramer's excoriating 1985 play on the impact of AIDS on New York City, the decision yesterday by Federal Health officials to advocate the use of PrEP for gay men who have sex without condoms is a dramatic game-changer that may herald the end of AIDS. Despite fierce resistance from some AIDS activists, who argue that reliance on PrEP (pre-exposure prophylaxis) will lead to a decrease in condom use and an increase in other sexually transmitted diseases, the wind is now firmly in the sails of the pro-PrEP lobby.
Yesterday, in a tweet picked up by Anderson Cooper, the activist Peter Staley, wrote, "Anti-PrEPers are losing because they are fighting sound science." And Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, told The New York Times that "I strongly support the C.D.C. doing this."
Although doctors advise patients to take the PrEP pill, Truvada, in conjunction with condoms, the move is an acknowledgement that after decades of public health education, condom use is in sharp decline among gay men. A C.D.C survey last November showed that the number of gay men reporting unprotected sex had risen nearly 20 percent from 2005 to 2011. Given the stigma around admitting to unprotected sex, that figure is probably much higher. Now, the hope is that by encouraging gay men who have unprotected sex to take Truvada, the number of new infections will continue to fall as scientists continue to hunt for a cure.
Last September, in article for Out, "Is This The New Condom?," writer Tim Murphy spoke to advocates who compared the impact of PrEP on HIV to the impact of the Pill on unwanted pregnancies in the 1960s. The article sparked a storm of controversy as readers argued over the pros and cons.
In recent weeks, some supporters of PrEP have taken to wearing #Truvada Whore T-shirts to challenge the moral indignation from activists who are "slut shaming" them by linking PrEP with promiscuity. The term comes from an article witten by David Duran for Huffington Post in 2012 that ishighly critical of PrEP. Duran has since changed his mind.
