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Thursday, September 18, 2014

Truvada For All: S.F.'s Gay Supervisors Lead the Fight in Different Ways

Posted By on Thu, Sep 18, 2014 at 2:51 PM

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It’s been a busy week for Supervisor David Campos. While yesterday’s meeting with Facebook executives to rethink their creepily totalitarian “real name” policy was unsuccessful, he led a rally at City Hall at 9 a.m. this morning calling for San Francisco to develop a plan for citywide access to Truvada, the drug intended for HIV-positive individuals to stay that way.

Currently, some 1,000 San Franciscans are taking Truvada, which the FDA approved in 2012 for pre-exposure prophylaxis (PReP), a huge sea change in the fight against HIV. In such a gay city, that number is far too low to put much of a dent in transmission rates, which remain stubbornly high — especially among gay men of color. (Of the 300 new cases in 2013, about 86 percent were among men who have sex with men.) Taken daily, Truvada can cost up to $12,000 a year, likely putting it out of reach for anyone with a bronze health plan. A similar program in Washington State could be a model for education and affordability.
The most obvious obstacle in the way of Campos’ plan is cost, but there are other practical issues. As the provisions of the Affordable Care Act have come into place, Healthy San Francisco — the obvious vehicle for such a comprehensive program — could wither away as the uninsured population creeps closer to zero. Further, court battles around the more controversial aspects of health care have left the system in flux. (Note: in American politics, AIDS prevention and contraceptives for women are frivolous things that denote irresponsibility and mooching, but Viagra is a sacrosanct wonder pill.)

However, Campos’ effort got a serious boost by Supervisor Scott Wiener, who revealed to the Huffington Post that he is in fact a “#TruvadaWhore.” Discourse surrounding HIV/AIDS has always been laced with misinformation, paranoia and questions about personal morality that are unhelpful when combating an epidemic, much of it from LGBT community. So an openly gay elected official being so candid about his status and prevention strategy gives the idea of universal PReP greater legitimacy.

(As something of an appeal to the LGBT activists who are frequently Wiener’s most strident critics, his admission might be tinged with a bit of calculation for his upcoming re-election and further ambitions.)

Truvada is a wonder drug, for sure, and its widespread use could curtail more than 90 percent of the 50,000 cases of HIV infection that occur in the U.S. each year. Fans of literary irony should note that its manufacturer is Foster City-based Gilead Sciences, and “Gilead” also happens to be the name of the homophobic Christian dystopia in Margaret Atwood’s The Handmaid’s Tale. But Truvada is not without drawbacks, either. Apart from forgetting to take your little blue pill, and the notion that HIV is a gay problem that straight people don’t need to worry about, it can also spur people to have unprotected sex.

A San Francisco of 2025 that’s been free of new HIV cases for years but is also crawling with antibiotic-resistant strains of the clap is a grim city indeed. But considering the lingering scars from the worst years of the AIDS crisis, this is a progressive move.

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Pete Kane

Pete Kane

Pete Kane is a total gaylord who is trying to get to every national park before age 40

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