Editor's Note: Guest blogger Damon L. Jacobs is a licensed psychotherapist and author in New York City. You can find out more about his unique approaches to health and wellness by visiting www.DamonLJacobs.com.
"If something comes along that's better than condoms, I'm all for it, but Truvada is not that. Let's be honest: It's a party drug." - Michael Weinstein, April 6, 2014
Although it has been nearly two years since the medication Truvada was originally approved by the FDA for use as pre-exposure prophylaxis (PrEP), there has been scant information published and distributed in the media about this life-changing tool. But all this changed greatly on April 6, 2014, when AIDS Healthcare Foundation President Michael Weinstein made the aforementioned "party drug" proclamation.
In the weeks since, there has been a whirlwind of dozens of blog posts, newspaper articles, and even an online petition to remove Weinstein that have inadvertently served to increase visibility, discussions, and information about PrEP to tens of thousands who had never heard of it before.
In retrospect, nearly every action Weinstein has taken against PrEP has backfired and achieved its opposite intent.
When Weinstein urged the FDA not to approve PrEP for HIV prevention in 2012, the government agency quickly passed approval. While he insisted that gay men couldn't adhere consistently to a prevention regimen, data proved that over half of men using PrEP in real-world settings had 96% protection or more.
When his Rose Parade float insisted that "Love Is The Best Protector," real world data proved that 68% of new HIV infections came from a "main" partner, thereby making "love" seemingly the worst protector. And finally, as Weinstein voraciously accused the PrEP pharmaceutical manufacturer Gilead of "Greed," his own financial mismanagement of AHF has come under the embattled scrutiny of the Los Angeles County Supervisor's Office.
What's even more incredulous is Weinstein's own flip-flopping on his support of using Truvada for PrEP. Although he is best known in the media for his opposition, he has made several statements conveying his agreement. Back in 2008, while the landmark iPrex study was showing promise, Weinstein acknowledged the hope of using Truvada for PrEP when he argued against government funding of HIV vaccine trials. In this Los Angeles Times opinion piece, Weinstein wrote:
"Currently, the AIDS vaccine establishment continues its taxpayer-funded, repeatedly unsuccessful search for a preventive AIDS vaccine while an alternative many have seen work on multiple levels -- successful antiretroviral treatment as both treatment and prevention -- goes unchampioned."
More recently, on November 9, 2013, Weinstein stated in a public forum: "If a person takes Truvada when they are supposed to, they take it every day, then their chance of becoming infected with HIV is close to zero."
So how does one go from strongly championing antiretrovial treatment as a prevention strategy that reduces the risk of infection to "close to zero" to speaking of PrEP as a "party drug?" One can only speculate on the political and financial motives for such zig-zagging, but truly only Weinstein himself can connect the dots.
What is abundantly clear at this point is that PrEP is here to stay, and there is nothing Michael Weinstein can do about it. The efficacy has been proven. The adherence is strong. The accessibility in Weinstein's own state has gotten simpler as California's Medical coverage has relaxed restrictions to prescriptions. Side effects have been shown to be quite rare. Most doctors approve of PrEP for their patients.
Without these arguments, all Weinstein has left are unscientific accusations, and baseless prophecies. Isn't it time that we shifted the spotlight from the bizarre rantings of one individual, and focused our time and attention on helping people understand clear and scientific information about appropriate use of PrEP?