You have probably seen the “I’m on the pill” commercial for Truvada. They show a diverse group of physically fit people, socializing in healthy activities —just like a beer commercial. But its not about beer, it’s promoting a drug that can reduce the chances that someone will contract HIV. That’s what “PrEP” means — Pre-Exposure Prophylaxis.
Lest you misconstrue what follows: Positively Waiting! supports ALL advances in the fight against HIV. We want those who have it to maintain their health and those who don’t have it to never contract it.
Having said that, there is no denying the fact that if every HIV-positive person refused to engage in the behaviors which transmit the virus, the AIDS epidemic could be eradicated in one generation. It may be a scandalous statement, but that doesn’t mean it isn’t true.
Anyway, back to the Truvada commercial. Whenever it comes on, this is how it sounds in my head.
Transcript: It’s a prescription medicine for adults that, taken every day, along with safer sex practices can help lower my chances of getting HIV.
Translation: Condoms are supposed to be 95% effective, but I take this pill every day to reduce that "leftover" 5% risk. [Wait, a DAILY medication is required decrease a 5% condom failure rate? Does that sound right to you?]
Transcript: I talked to my doctor, and he said because I have a higher chance of getting HIV through sex, Truvada might be an option for me.
Translation: I have a higher chance because I am gay, bisexual, or transgendered; a member of the Black or Latino community; living in the South or the Midwest; and/or an injected drug user [according to Hiv.gov].
Transcript: [My doctor] also told me Truvada alone may not keep me from getting HIV and it does not prevent other STIs or pregnancy.
Translation: Like all sexually active people, I am at risk of contracting other much more common diseases,which Truvada doesn’t prevent. And if I don’t want to make any unexpected babies, I must add birth control.
Transcript: You must be HIV negative to take Truvada for PrEP, so you need to get tested for HIV immediately before and at least every 3 months, while taking Truvada.
Translation: One in 7 people with HIV are unaware they have it and could transmit it to others, so I need to find out if my previous choices had consequences. If I have dodged that bullet, as I still need to get tested every Winter, Spring, Summer and Fall for as long as I am sexually active.
Transcript: If you think you may have been exposed to HIV or have flu-like symptoms, tell your doctor right away. They may do more testing to confirm you’re still HIV negative.
Translation: When I have sex with someone in a high-risk group (gay, bisexual, transgendered, IV-drug user or person of color), and every time I feel under the weather, the makers of Truvada suggest I take another HIV test. And since no HIV test is effective immediately after infection, (usually takes 3 to 12 weeks to develop detectable antibodies), until my test results come back, a sically responsible person would abstain from sex to avoid putting someone else at risk.
The closing is a long list of the serious side effects of taking Truvada which (like most meds) sound just as bad as what they are designed to prevent.
Do you hear what I hear?
In my head, this commercial sounds like 35 years of HIV at epidemic levels, people STILL don’t understand or care that their behavior can affect and endanger others. So the social action step, according to commercials like this one, is to promote a health strategy which:
Requires taking a pill daily (and only 18% of study participants did)
Along with consistent condom use (less than half of sexually active adults use condoms with every sexual contact)
… in hopes it MAY decrease the life-threatening consequences of risky behavior (their language not ours).
This prevention strategy also relies on convincing high-risk populations to get tested and retested, with every new partner -- Winter, Spring, Summer and Fall. This is the same HIV prevention strategy which has never been successful in spite of spending billions of dollars over 30+ years to convince people of its importance.
There are those who say asking HIV+ patients to refrain from the behavior which transmits the virus, is too much to ask. The irony is, many people who believe sexual self-control is “too much to ask” to end the AIDS epidemic have no problem demanding that every man, woman and child change their own personal conduct for the sake of the public good (i.e.; recycle, adopt gender-neutral pronouns, cart around reusable grocery bags, etc.)