This week, the Los Angeles County Board of Supervisors approved a motion to finally develop a comprehensive program that makes Pre-Exposure Prophylaxis (PrEP) available in the L.A. area, in order to prevent HIV transmission.
PrEP — marketed as Truvada — is a groundbreaking drug that helps reduce the risk of contracting HIV by up to 99%. All it takes is a daily pill, with very minor (and in most cases non-existent) side effects, to give HIV-negative people a peace of mind that many of them never thought possible in their lifetime.
It’s been three years since the U.S. Food and Drug Administration approved the medication, and in the past year several public agencies across the country — most notably in New York City, Chicago and Washington State — have been distributing it to great success. Yet somehow Los Angeles, the town with the second largest HIV epidemic in the nation, has yet to launch a program that supplies PrEP to those at highest risk.
Nearly 60,000 people in the L.A. County are living with HIV, and approximately 1,850 residents become infected each year. So you might be asking, why are County officials taking so long to help a community that clearly needs it?
Well, most proponents are blaming it on one man: Michael Weinstein, President of the AIDS Healthcare Foundation, an institution widely known as one of the largest HIV medical providers in the world, with an annual budget of about US$1bn and more than 400,000 patients in 36 different countries. But while those stats are impressive, many people believe these numbers might be giving Weinstein too much influence when it comes to medical care policies.
Weinstein caught a lot of heat — especially from the gay community — by calling Truvada a “party drug.” He has openly dismissed the medication’s results, and has claimed that by users possibly forgetting to take their daily dosage of Truvada, infection probably wouldn’t be averted.
One of Weinstein’s main arguments when confronted with PrEP’s excellent preventive results has been that its consumers are mostly white privileged people, and not quite from the demographics that are most likely to be at risk. However, that is precisely why a dedicated program would be highly beneficial. Weinstein’s public campaign to discourage the use of Truvada isn’t just promoting condom use, but denying many people an option that could help to keep them safe from contracting HIV.
Weinstein is infamous — and fairly disliked — around the adult industry, as he’s been the most vocal proponent of Measure B, the law that requires mandatory use of condoms in all vaginal and anal sex scenes shot in the L.A. County. Measure B has been a big reason for the geographic shift that’s moved many porn shoots to more permissible areas, and is costing the State of California millions of dollars in tax revenue.
After recent moratoriums when adult performers have tested positive, the case for mandatory condom use made bigger headlines, and pushed the reform that has threatened to take the industry away from Southern California.
“The reality is their legislation, AB 1576, wouldn’t have stopped the performers from contracting HIV.” Kink.com founder Peter Acworth told the New York Times in 2014. “Had these performers been taking Truvada, on the other hand, they still could be HIV negative. We owe it to performers and other sex workers to move beyond old models of prevention and educate them about all the safeguards at their disposal — including PrEP — and let them decide for themselves whether they are taking risks that might be mitigated by use of PrEP. Morality and politics shouldn’t cloud prevention, on-set or off.”
“Decide” is the key word. While no one is denying that the use of condoms is still the safest way to prevent STDs, it all still comes down to personal choice. If there is a drug that the FDA has ruled safe and effective to prevent the HIV epidemic from spreading even more, it should be people’s own decision whether they’d like to take it or not. Furthermore, if a public agency is willing to develop programs to assist those at higher risk, discouraging them is a major disservice to a community that could clearly use all the help they can get.
“There is no single prevention program or tool, including risk reduction education or condom distribution, which will completely curtail the spread of HIV on its own,” said the motion introduced by Supervisor Sheila Kuehl. “The Plan calls for the implementation of new and effective prevention methods and recommends that ‘new paradigms for prevention, testing, linkage to care, and care services’ be developed. Recent research demonstrates that one such new method is the broad and unhindered availability of Pre-Exposure Prophylaxis for HIV.”
The Board of Supervisors is scheduled to take up Kuehl’s proposal and develop a program that could make PrEP widely available in L.A. The three-year delay has given the launch an even bigger sense of urgency.
“Considering there are almost 2,000 new HIV infections annually,” Kuehl’s spokesperson, Joel Bellman, told BuzzFeed News, “a two-year delay could mean nearly 4,000 people were exposed and infected while the bureaucratic process slowly grinds on.”
Ending the epidemic is easier said than done, but curbing new infections is obviously the best step in that direction. This is a good week for Los Angeles.