PreP: Prevention or Problem?


I’ve been reading about PreP lately—pre-exposure prophylaxis. Ever hear of it? They’re pills for HIV prevention. There’s a few of them—tenofovir and nevirapine are the front-runners. They’re being tested in small consensual trials to see if antiretrovirals can help prevent HIV infections.

You’ve heard of how people with a risk of catching malaria take anti-malarial drugs before they enter that situation, right? PreP trials test antiretrovirals in a similar fashion to prevent HIV transmission. The theory is that continued antiretroviral exposure will reduce HIV infection risks. These drugs could help prevent the spread of HIV/AIDS among high-risk
populations (like commercial sex workers) and slow the rise of AIDS

Now for the opposition. Some—including some news reports out there—suggest that gays will use PreP as a condom replacement. They think a pill that helps prevent HIV infection would lead to more high-risk sex. Seems to me folks made that shrill argument 40-odd years ago —“That Pill will lead to promiscuity and moral turpitude!”

What a load. “The Pill” didn’t lead to the downfall of humanity and PreP pills won’t either. PreP opponents often fail to address (or think through to) the huge difference between a drug that prevents pregnancy and one that helps prevent transmission of a very lethal disease.

Here’s my main outrage—the knee-jerk assumption that something that may prevent HIV leads (in their minds) to more high-risk sex (homo, hetero, or otherwise) that ignores common sense. For 30+ years, we’ve known that condoms are the best defense against HIV/AIDS outside of the horrible option of no sex at all. Why would we throw that out simply because the chances and the drugs got better? I sure as hell wouldn’t. Would you?

PreP drugs could potentially make the lives of gay men a whole lot safer…but only if they’re used as an additional prophylactic. But are nay-sayers right? Would PreP drugs lead to behavior like the pre-HIV eras? Would they lead to more, not less, HIV/AIDS?

Tags: Lifestyle