Here’s why this gay Atlantan won’t take PrEP

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Atlanta author and longtime sex advice columnist Michael Alvear is no stranger to controversy. Now the “Need Wood” writer dives headlong into the PrEP debate and says he refuses to take it.

We’ve covered lots of reasons that the predominant view is to enjoy butt sex with Truvada. The AIDS drug shows a significantly high success rate at preventing HIV infection if taken regularly as PrEP – or Pre-Exposure Prophylactic – by guys who are HIV-negative – when they stick to the regimen.

Alvear, who you may know best from his “Need Wood” gay sex advice columns, has a very different take on the Truvada regimen as PreP. He spells out why he wouldn’t touch it with a 10-foot pole in a well-written essay for Huffington Post. A friend told him that refusing to take the drug makes him like the Anti-Vaxxers who refuse to immunize their children.

Are guys like me the new anti-vaxxers? Are we endangering other gay men by refusing to take the drug? Are we stubborn anti-science rubes who distrust the medical establishment to the point that we're harmful to those around us?

Sure sounds like we are. We see the studies on Truvada and they are remarkable. The results are so close to 100 percent prevention that some have taken to calling Truvada the closest thing to an AIDS vaccine that we've ever had. Yet we refuse to take it.

But the anti-vaxxer epithet, which my friend and a growing number of AIDS service workers are using to pressure the “hold-outs,” doesn't hold up. First, Truvada is not a vaccine; it's a medication. You have to take it every day for the rest of your life (or for as long as you stay sexually active). Stop the medication, and you stop its effectiveness.

The good news before you jump on the Shame Alvear Wagon is that he, like so many, is against the efforts of AIDS Healthcare Foundation president, AID Atlanta ally, and PrEP naysayer Michael Weinstein, who ignores the evidence. Alvear concedes the science, but still has his reasons.

My objection has nothing to do with the science; it has to do with the unintended consequences of taking such a powerful drug.

Am I willing to go through some of Truvada's nastier side-effects like nausea and diarrhea for days, weeks and sometimes months before it goes away? No.

Am I willing to risk kidney or liver failure for protection against a disease that I've managed to avoid for the last 20 years? No.

Am I willing to curtail the quality of my life to pay for the substantial after-insurance deductible costs that Truvada would burden me with? No.

He goes on to say that he would answer those questions differently if he were practicing unsafe sex or taking intravenous drugs, that all drugs are a trade-off with side effects, and that he eats organic. Huh? Yeah, it’s in there. Something about what you put in your body and unknown future cancers that Truvada might cause.

All in all, we cannot agree, but we can respect anyone’s decision not to take a drug or employ one prevention method over another. In a mostly reasoned argument, even Alvear admits he’s grateful to have the option in his arsenal of prevention choices.

The friend who called me an “anti-vaxxer”used to work at an AIDS services organization and he, along with others, seems to have taken on the fervor of right wing fundamentalists convinced that anyone who doesn't see things their way is deaf, dumb or worse, a Democrat.

In their understandable zeal to decrease HIV infection rates, some AIDS service folks have adopted the “divide and conquer” tactics of social conservatives: You're either part of the problem or part of the solution. You're either with us or against us. You're either a Truvada believer or an anti-vaxxer.

None of this is surprising to longtime followers of Alvear’s columns and books. He doesn’t care who he pisses off when he believes in something, and lord knows Alvear can take the hits as good as he gives them.

[Huffington Post]


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