Among the greatest obstacles to promoting PrEP as an invaluable tool for HIV prevention has been the prominence of its naysayers, like Larry Kramer and Michael Weinstein. Kramer, a cofounder of the Gay Men's Health Crisis, is also the revered author of Faggots and The Normal Heart. So people took note when, just days after the Centers for Disease Control and Prevention published national guidelines that included PrEP in its HIV prevention strategy, Kramer spoke out against people who take it.
"There's something to me cowardly about taking Truvada instead of using a condom," Kramer told The New York Times. "You're taking a drug that is poison to you, and it has lessened your energy to fight, to get involved, to do anything."
More problematically, Michael Weinstein, the president of the AIDS Healthcare Foundation, is using the brand and the resources of one of the world's largest HIV and AIDS organizations to launch an anti-PrEP campaign, which raises red flags about its efficacy if not taken properly but does little to educate about its enormous potential to help end HIV.
As a counterbalance to these influential voices, The Advocate has reached out to and compiled quotes from prominent individuals, including doctors, activists, leaders of health organizations, and other well-known proponents of PrEP, which has been shown to reduce the risk of HIV infection by up to 99 percent if taken daily as directed. Find out why the World Health Organization, Gov. Andrew Cuomo, and Kramer's alma mater, the GMHC, along with many others, are saying yes to PrEP. Those without quotations did not release a formal statement, but wanted to be included in the list of supporters.
Do you support use of PrEP? Leave your reason why in the comments below. And be sure to follow The Advocate's monthlong series of articles, "31 Days of PrEP."
World Health Organization: "For the first time, WHO strongly recommends men who have sex with men consider taking antiretroviral medicines as an additional method of preventing HIV infection (pre-exposure prophylaxis) alongside the use of condoms. Rates of HIV infection among men who have sex with men remain high almost everywhere and new prevention options are urgently needed. Modelling estimates that, globally, 20-25 percent reductions in HIV incidence among men who have sex with men could be achieved through pre-exposure prophylaxis, averting up to 1 million new infections among this group over 10 years." [WHO]
Ian Thompson, Legislative Representative, ACLU Lesbian Gay Bisexual and HIV Project: "It is important for the response to HIV to always be based on what the science tells us. PrEP has been demonstrated to vastly reduce the risk of contracting the disease and additionally, it would enable those at the greatest risk of contracting HIV to exercise greater control over their medical care. The government should ensure it is doing all that it can to remove any barriers - including financial - that would prevent those who wish to use PrEP from being able to do so."
The Centers for Disease Control and Prevention now recommends PrEP's use for any "gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months. ... PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every three months." [CDC]
Jeremy Balli, Health Care Professional: "You deserve to navigate your sexuality with empowerment and safety. Love and sex do not have to be a battlefield, and it's time we accept that there is the possibility of a future where we're not on opposing sides (poz and neg), and we don't have to go into it wearing armor and the scars of past fears." ["Men of Color Explain Why They Take PrEP"]
AVAC: "Recent clinical trials have shown clearly that daily, oral pre-exposure prophylaxis (PrEP) using the antiretroviral drugs tenofovir and emtricitabine dramatically reduces the risk of HIV infection for men and women who take it as directed. While PrEP won't be right for every individual at risk for HIV, untold numbers of men and women will benefit -- if they can access this potentially life-saving option." [AVAC]
Devin Barrington-Ward, Health Equity Professional: "PrEP is merely a tool in our prevention toolbox, and we should be empowering people with the facts about PrEP, not stigmatizing or shaming people for wanting another prevention option outside of condoms." ["Men of Color Explain Why They Take PrEP"]
Calvin Stowell, Director of Digital and Content, DoSomething.Org: "I am for any and every measure that helps prevent the spread of HIV. PrEP, in coordination with condoms and better education about the virus, could help us see the end of the HIV epidemic. We should all be working together to make sure everyone, regardless of age, race or class can access any and every tool necessary to prevent HIV, and PrEP is one of those tools."
Mathew Rodriguez, Community Editor, TheBody.com: "I think PrEP is useful, but there are people for whom it may not be the best option, so it's really a 'Know thyself' situation. But, if it is an option you want to pursue, know that you must be the best advocate for your own health, and there may be a lot of obstacles in your way -- fussy doctors, insurance red tape, pharmacy problems. Be ready to combat them, and if you need help, don't hesitate to reach out to someone." ["Men of Color Explain Why They Take PrEP"]
Zack Ford, Editor, Think Progress: "Knowing your status and reducing the risk of transmission is common sense. PrEP is an easy way to resist the HIV epidemic, and we should celebrate those who take steps to keep themselves and others safer."
Matthew Murguia, Federal Employee and HIV Activist: "The research is clear. When used correctly and consistently, PrEP can help reduce new HIV infections. The question is why more folks are not using it." ["Op-ed: We Need Every Tool to End HIV"]
R.J. Aguiar, YouTube Personality and Bisexual Activist: "HIV infections are on the rise again. It makes no sense not to use every tool at our disposal to put a stop to it, or to shame members of our community for using them. Period."
Christopher Glazek, Executive Editor, Genius.com: "It's good politics to be on PrEP -- it's good to want the AIDS epidemic to end. It's also good to be able to truthfully say to your poz friends, 'This is literally something that doesn't even potentially matter to me.' Sexual exclusion of poz people is a very real and very shitty thing. When you go on PrEP, you're not neg or poz anymore -- you're 'post.'" ["Men on PrEP Explain Why They Take It"]
Corey Johnson, New York City Council Member: "It's simple: PrEP has been proven to work, and at the end of the day that's what matters. PrEP isn't a cure-all but an important piece of the puzzle in how to prevent new HIV infections."
Eric Evans, Vice Chair, Louisiana AIDS Advocacy Network: "Our organization strongly endorses PrEP as a means to reduce HIV transmission for those who are HIV-negative and for serodiscordant couples. LAAN has looked carefully at the pros and cons of PrEP, reaching a conclusion that PrEP makes sense as a tool preventing the spread of HIV. Also, as I am a longtime advocate for same-gender marriage, I must admit, this is an awkward obstacle for couples who find themselves in this situation. In the past, if two people fell in love and one was HIV-positive and the other HIV-negative, having a worry-ree sex life without concerns of 'Did I expose my loved one?' was next to impossible. Today, effective treatment is excellent at keeping viral loads undetectable in people living with HIV and making transmission of HIV negligible. Furthermore, studies have consistently demonstrated the use of PrEP is highly effective in keeping people HIV-negative. Such past concerns and worries about transmission are strongly diminished. I am advocating this for a wonderful young couple I have come to know here in northwest Louisiana."
Bria and Chrissy, YouTube Personalities
Vallerie D. Wagner, COO, APLA Health & Wellness: "Supporting PrEP means more than just telling someone to take a pill. It means, over three decades into the epidemic, that we support a new tool in the arsenal against HIV/AIDS. It means, along with the implementation of the Affordable Care Act, that we have an opportunity to get many more MSM of color and transgender individuals into a culturally competent health care setting to talk with them, learn from them, and help them make positive choices. We support PrEP because we have opened a health center for the LGBT community that includes comprehensive counseling and doctor-managed care of Truvada -- and we are committed to changing things for the better."
Kelsey Louie, CEO, Gay Men's Health Crisis: "While HIV and AIDS may no longer be a death sentence, there have been 50,000 new HIV infections every year for the past decade -- and it's going to stay that way unless we all step up now. GMHC's goal is to end the HIV and AIDS epidemic in New York State by 2020, and we're advocating for the widespread adoption of PrEP to help get it done. Can you imagine how quickly we would have embraced a pill like PrEP that was over 90 percent effective in preventing HIV infections during the height of the crisis? If every New Yorker at risk of HIV infection had affordable access to these resources, we could save more lives and end this epidemic once and for all."
Eric Paul Leue, Mr. L.A. Leather 2014: "PrEP and its biochemical prevention brothers are a turning point in 35 years of this epidemic. PrEP is the most efficacious HIV prevention method for HIV-negative people, [treatment as prevention] renders the virus just about nontransmissable, and [post-exposure prophylaxis] is always there if other efforts didn't go as planned. Whoever denies the science that stands behind it and stands in the way of progress to end this epidemic is the climate-change-denier of HIV prevention."
Scott Wiener, San Francisco City Supervisor: "As an elected official, disclosing this personal health decision [to be on PrEP] was a hard but necessary choice. After all these years, we still see enormous stigma, shame, and judgment around HIV, and around sexuality in general. That is precisely why I decided to be public about my choice: to contribute to a larger dialogue about our community's health." [The Huffington Post]
James Loduca, VP of Philanthropy at San Francisco AIDS Foundation (In response to Wiener's coming out as on PrEP): "We need more people like Supervisor Wiener. In my own personal network, many of my HIV-negative gay male friends are on PrEP. None of them talk about it publicly, and that is a reflection of the enormous stigma and shame that we still have around sex, around a desire to have intimacy. ... It's an important watershed moment for our community that someone so visible steps forward and says 'PrEP is helping me.'"[NPR]
Jim Pickett, Director of Prevention Advocacy, AIDS Foundation of Chicago: "I support all ways to engage in safer sex, and that definitely includes PrEP. I especially love PrEP because it puts bottoms of all genders in control -- it need not be negotiated with your boyfriend, your husband, your hook-up, or your friend with benefits. PrEP is your decision. And it doesn't need to be taken in the heat of the moment when your hormones are raging and your fingers are sticky."
Jeff Berry, Director of Publications, Test Positive Aware Network: "I recently sat in on a support group for newly diagnosed individuals, and I remember asking myself, How have we failed these young gay men? What are we doing wrong? I believe that PrEP, as part of a comprehensive prevention package that includes access to condoms, testing, education, and increasingly, other biomedical interventions, will finally help to turn the tide and someday make those support groups a relic of the past."
David Campos, San Francisco City Supervisor: "PrEP is the first new tool in our fight to protect ourselves from HIV since the epidemic began." [NPR]
Grindr: "As the largest gay network, with more than 5 million active monthly users, Grindr is a powerful platform to raise awareness on important issues for the gay community around the world. We launched Grindr for Equality to spur action on a variety of causes, as well as gay men's health issues such as HIV/AIDS and most recently PrEP awareness. Actions can take the form of signing petitions, donating money to a worthy cause, or participating in a specific call to action. To date, Grindr has helped raise awareness surrounding numerous PrEP initiatives, including studies and information sessions. Grindr is highly committed to promoting safe sex within the community and strongly encourages our users to engage in safe sex practices, get tested and know their HIV status." [Grindr.com]
Jay Gladstein, MD, HIV Specialist: "Concerns with toxicity and long-term harm have been overemphasized when they really don't exist for the most part. The bottom line is, it's a powerful tool when used correctly, and it could turn the tide in new transmissions. And that's something we've not been able to do in the past 33 years." ["As PrEP Becomes More Widely Available, Couples With One Poz Partner Consider Treatment"]
Charles Stephens, Director of Counter Narrative: "I think [PrEP] is also a part of our sexual rights. As black gay men we absolutely have a right to pleasure, we have a right to health; we have a right to every tool that's available to protect ourselves. There are arguments that suggest by having access to PrEP it will increase condomless sex and it will make people less afraid of HIV. I believe those arguments are rooted in a very moralistic and judgmental lens around sexuality." [GA Voice]
Andrew Cuomo, Governor of New York, on the state's "Bending the Curve" plan to provide PrEP to high-risk groups: "New York State has reached an important milestone in controlling the AIDS epidemic, and through this comprehensive strategy, we are decreasing new HIV infections to the point where by 2020, the number of persons living with HIV in New York State will be reduced for the first time." [New York Governor's Office]
Tank Teachworth, Former Mr. Atlanta Eagle and American Leatherboy Title Holder: "Sometimes in leather things can get intense and sometimes condoms can break. Nothing is foolproof. I wouldn't call myself an exceptionally promiscuous person, but I like to have fun. If there's another opportunity to stop one more case of HIV transmission then I feel PrEP is worth it. If I make a connection with somebody I'd like to do so responsibly." [GA Voice]
Chad Griffin, President of the Human Rights Campaign: "Today, there is an unprecedented chance to end the HIV/AIDS epidemic, in part through PrEP's aggressive prevention of new HIV infections. There is no reason -- medical or otherwise -- to discourage individuals from taking control of their sexual health and talking to their doctor about PrEP." [HRC]
Tyler Curry, Senior Editor, HIV Equal: "If you have had sex even once since your last HIV test without a condom, it is worth it to educate yourself on PrEP and determine if it is right for you. It only takes one time to transmit the virus, and it only takes one pill a day to stop it." [The Huffington Post]
Peter Staley, HIV activist: "Everybody looks at costs of Truvada, fears of toxicity -- those are all the challenges and questions facing the person who has already decided to look at this option. That's not the underlying problem. The problem is that very few people even consider the option. And the reason for that is HIV-related stigma." [Slate]
Michael Lucas, CEO of Lucas Entertainment: "People don't talk about PrEP enough. When things aren't talked about, there is stigma. But we both agree the stigma that comes with HIV infection is far more damaging than the stigma associated with PrEP. People need to be educated and take the steps to protect themselves regardless of what people think." ["Men on PrEP Explain Why They Take It"]
Damon L. Jacobs, Activist: "PrEP has changed my dating life, because it has completely removed the fear of HIV from sex. I had never experienced sex without fear in my life. As the receptive partner, I had always made my HIV status contingent on the 'top' using a condom, making sure it didn't fall off, fall in, or break. With PrEP, I could make rational decisions about my sexual choices and still remain 100 percent in control of my negative HIV status. That has increased my romantic and sexual connections greatly."
Jack Mackenroth, HIV Activist: "We now have a drug that can make HIV-positive men undetectable and therefore non-contagious. That same drug can make HIV-negative men impermeable to HIV infection. We have a tool that could stop HIV infection in it's tracks. I have taken Truvada for seven years with no side effects. Condom only messaging has proven to be unsuccessful for the past 30 years. You can either get on board with PrEP or you can argue against it. Simply put, you are either part of ending the epidemic or you are part of the problem."