I stumbled upon a VICE documentary titled “The end of HIV? The Truvada Revolution.” This caught my immediate attention. In the United States, there are 50 thousand new HIV infections each year. AIDS has killed over 39 million people worldwide. July of 2012 the FDA approved Truvada as a HIV preventive medication. Truvada has been around for years to treat people diagnosed with HIV. Now called PrEP (pre-exposure prophylaxis) is two drugs combined (Tenofovir and Emtricitabine) that blocks the HIV life cycle and replication of the virus in a single pill that must taken daily to prevent HIV transmission. The side effects include decreased bone mineral density along with decreased kidney function and abdominal upset.
In this documentary, Dr. Howard Grossman (Former Director at American Academy of HIV Medicine) explains his protocol for his patients who go on PrEP. A check-up every 3 months, speak about sexual activity, how often the patient takes the drug. Blood is drawn for HIV and STD testing. Dr. Grossman does testing to make sure Truvada is not seriously affecting the kidneys.
Part one Damon L. Jacobs ( a patient of Dr. Grossman) explains to his doctor “ with science and the FDA approval of Truvada, I feel assured that PrEP will protect me if I was exposed to HIV. And for the most part I gave up using condoms and now I don’t use condoms with my sexual encounters, not with people who are positive, not with people who are negative-identified.” Dr. Grossman asks, “Do you worry about STD’s at all?” Damon replies “I’m concerned about STD’s but I’m not gonna worry about STD’s I feel like I’ve lost enough of my life losing sleep over consequences of sexual behavior.”
In a separate interview Michael Weinstein (Co Founder and President of AIDS Healthcare Foundation) says “I saw hundred and hundreds of people perish. As an member of the older generation that lived through the worst of it I feel I have a moral responsibility to tell young people where things are at whether they want to hear it or not. So the question about PrEP is, does the scientific data support it as a public health intervention? And that answer is conclusively no. Adherence is a huge obstacle. Getting people to take their medication everyday is very difficult. So when you’re looking to control the spread of HIV across a whole population group it has not been effective.”
Part 2 Dr. Robert M. Grant (Senior Health Investigator) at Gladstone Institutes in San Francisco, California tells VICE “We are seeing that PrEP is rolling out primarily among well resourced, well privileged people.” Kimberleigh Smith (V.P of Policy & Advocacy of Harlem United) believes “HIV bares a disproportionate burden on communities of color. Black and brown communities lack the access that our white counterparts have to healthcare. PrEP is more than just the pill. PrEP involves the cost of care and resources involved in getting care to folks. So it’s the lab work, the testing and the cost of visits has to be sort of accounted for when your trying to make PrEP accessible to people.”
VICE interviews Lorena Borjas, as she only speaks Spanish, subtitles to translate. “I am Mexican, Hispanic, Latina, I identify as a transgender woman. Many of these girls that I reach out to don’t know that Truvada exists. So there’s a barrier to accessing these services. To be a transgender woman, to be an immigrant, and to not speak English is a very difficult problem. Many clinics don’t have translators. They don’t have means to look after patients who speak Spanish.”
Part 3 begins back with Damon L. Jacobs speaking with high emotion” I didn’t know how much fear was part of every sexual encounter I had and every sexual thought I had through out my entire adult life. I did not even begin to unravel that until I started using PrEP and that fear started to lift. I’m still unpacking how profound that is.”
Michael and Leo, a gay couple that have been in a relationship for a little over one year interview next. Michael expresses “I am an HIV carrier, but I am undetectable which means I am on HIV treatment that suppresses the virus in my body to undetectable levels. It’s not something I feel afraid of or ashamed of. For me it’s just important that it doesn’t get pass me. I don’t want to give it to anyone else.” Leo is HIV negative who heard about Truvada in 2010. Leo has his reservations and concerns although he says “sometimes you have to just go on the side of hope with things and hope for me a year ago was to leap frog pass this issue or this virus or whatever and it really did. Whatever issues we have with the relationship, none of them are HIV-related and that blows my mind.” With a smile on his face, he says, “That’s the best feeling ever.” Michael ends on a note that I support and deeply believe. “Know your status really means get tested. And if you are positive you can get treated for it so you’re not at risk of infecting someone else.”
Dr. Robert M. Grant believes HIV is a stigmatized infection. At the end of the documentary, he goes on to say, “the fact that it’s still spreading around the world at root is because of stigma. My hope is that as we talk more about PrEP people will have a chance to reconsider their attitude about HIV. It’s not part of people’s identity. Its just a thing that some people have. It is manageable thing that we can help each other through.”
I do agree PrEP should be an option for those highly at risk for contracting HIV. Since the official FDA approval of Truvada, many have ignored condoms all together. Increased risk is possible to men who believe only PrEP will protect them from HIV. Without condoms, we leave an open door (literally) to contract an STD. Thorough education and information is important. We must not wait for HIV to attack our bodies to make a change. The time is now. We should encourage our generation and the next generations to talk more openly about sex and test regularly for HIV and STD’s.
In this documentary, Dr. Howard Grossman (Former Director at American Academy of HIV Medicine) explains his protocol for his patients who go on PrEP. A check-up every 3 months, speak about sexual activity, how often the patient takes the drug. Blood is drawn for HIV and STD testing. Dr. Grossman does testing to make sure Truvada is not seriously affecting the kidneys.
Part one Damon L. Jacobs ( a patient of Dr. Grossman) explains to his doctor “ with science and the FDA approval of Truvada, I feel assured that PrEP will protect me if I was exposed to HIV. And for the most part I gave up using condoms and now I don’t use condoms with my sexual encounters, not with people who are positive, not with people who are negative-identified.” Dr. Grossman asks, “Do you worry about STD’s at all?” Damon replies “I’m concerned about STD’s but I’m not gonna worry about STD’s I feel like I’ve lost enough of my life losing sleep over consequences of sexual behavior.”
In a separate interview Michael Weinstein (Co Founder and President of AIDS Healthcare Foundation) says “I saw hundred and hundreds of people perish. As an member of the older generation that lived through the worst of it I feel I have a moral responsibility to tell young people where things are at whether they want to hear it or not. So the question about PrEP is, does the scientific data support it as a public health intervention? And that answer is conclusively no. Adherence is a huge obstacle. Getting people to take their medication everyday is very difficult. So when you’re looking to control the spread of HIV across a whole population group it has not been effective.”
Part 2 Dr. Robert M. Grant (Senior Health Investigator) at Gladstone Institutes in San Francisco, California tells VICE “We are seeing that PrEP is rolling out primarily among well resourced, well privileged people.” Kimberleigh Smith (V.P of Policy & Advocacy of Harlem United) believes “HIV bares a disproportionate burden on communities of color. Black and brown communities lack the access that our white counterparts have to healthcare. PrEP is more than just the pill. PrEP involves the cost of care and resources involved in getting care to folks. So it’s the lab work, the testing and the cost of visits has to be sort of accounted for when your trying to make PrEP accessible to people.”
VICE interviews Lorena Borjas, as she only speaks Spanish, subtitles to translate. “I am Mexican, Hispanic, Latina, I identify as a transgender woman. Many of these girls that I reach out to don’t know that Truvada exists. So there’s a barrier to accessing these services. To be a transgender woman, to be an immigrant, and to not speak English is a very difficult problem. Many clinics don’t have translators. They don’t have means to look after patients who speak Spanish.”
Part 3 begins back with Damon L. Jacobs speaking with high emotion” I didn’t know how much fear was part of every sexual encounter I had and every sexual thought I had through out my entire adult life. I did not even begin to unravel that until I started using PrEP and that fear started to lift. I’m still unpacking how profound that is.”
Michael and Leo, a gay couple that have been in a relationship for a little over one year interview next. Michael expresses “I am an HIV carrier, but I am undetectable which means I am on HIV treatment that suppresses the virus in my body to undetectable levels. It’s not something I feel afraid of or ashamed of. For me it’s just important that it doesn’t get pass me. I don’t want to give it to anyone else.” Leo is HIV negative who heard about Truvada in 2010. Leo has his reservations and concerns although he says “sometimes you have to just go on the side of hope with things and hope for me a year ago was to leap frog pass this issue or this virus or whatever and it really did. Whatever issues we have with the relationship, none of them are HIV-related and that blows my mind.” With a smile on his face, he says, “That’s the best feeling ever.” Michael ends on a note that I support and deeply believe. “Know your status really means get tested. And if you are positive you can get treated for it so you’re not at risk of infecting someone else.”
Dr. Robert M. Grant believes HIV is a stigmatized infection. At the end of the documentary, he goes on to say, “the fact that it’s still spreading around the world at root is because of stigma. My hope is that as we talk more about PrEP people will have a chance to reconsider their attitude about HIV. It’s not part of people’s identity. Its just a thing that some people have. It is manageable thing that we can help each other through.”
I do agree PrEP should be an option for those highly at risk for contracting HIV. Since the official FDA approval of Truvada, many have ignored condoms all together. Increased risk is possible to men who believe only PrEP will protect them from HIV. Without condoms, we leave an open door (literally) to contract an STD. Thorough education and information is important. We must not wait for HIV to attack our bodies to make a change. The time is now. We should encourage our generation and the next generations to talk more openly about sex and test regularly for HIV and STD’s.
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