Tuesday 31 March 2015

What They Don't Want You to Know about Truvada

Truvada prevents AIDS.
Wow. What a headline. You'd think you'd see it on the front page of the New York Times!
Well, don't hold your breath.
Truvada -- when taken by someone who is HIV negative -- is very very effective at protecting you from HIV. Let me put it in a way that might have the most pragmatic value for the gay-man-on-the-street today. If you are HIV positive and you are on HIV medication (and you have an undetectable viral load) you can have unprotected sex with your partner who is HIV negative and taking Truvada and the risk is exactly the same as wearing condoms (i.e. practicing safe sex).
Unfortunately not everyone is interested in spreading the good news. Truvada is proving as controversial for gay men as birth control was for women in the 1960s.
Nowadays, we look on the birth control pill as an unqualified success. The pill radically changed women's lives, liberating them, making them happier, healthier, and able to control their futures. Without the threat of unwanted pregnancies, women pursued careers once reserved only to men, steering their lives in unimaginable ways. But back in the early 60s, some were opposed to birth control. They argued that if women were freed from the fear of unwanted pregnancy, they would become more promiscuous. This was reason enough to want to hide the truth from tender feminine ears.
Similarly, some people have tried to discourage gay men from using Truvada. Larry Kramer has said  "Truvada is for cowards." The fear (much like the fears about women and birth control) is that gay men armed with Truvada will go crazy and have unprotected (i.e. bareback) sex. And what should be important news shouted from every rooftop has barely made it into the headlines.
Sure it's possible that some gay men may misuse the new discovery. Truvada is most effective when it is used along with condoms. Truvada protects you from HIV, but not not from other sexually transmitted diseases - especially particularly lethal ones like Hepatitis C.
But many gay men have lived the past thirty-five years in shame and fear. They came to believe their own bodily fluids were lethal. For these men, AIDS has not only caused unbelievable suffering and killed their friends - but it has ruined sex. The idea that sperm is so terribly dangerous has,  paradoxically, eroticized practices that up until now, have been deemed risky for gay men. So yes, those of us who have felt unhappy with safe sex practices may be more than eager to say goodbye to the fear and loathing that has consumed our lives; i.e. we may prefer to live (at our own peril) in a condom-less world.
But is that a reason to hide this very important scientific information?
Already the Truvada debate has taken on a nasty tone, evident in the surfacing of the slang term "Truvada Whore" - a moniker some gay men have been rebelliously eager to own and flaunt.
But just as with birth control, we mustn't allow our moral judgements to stop the free flow of information. Policing gay men's bodies and/or women's bodies does not work. Treating them like children does not work. Hiding the truth does not work. Respecting their right to make adult decisions with the proper information most certainly does.
Knowledge is morally neutral - even though it is sometimes used for the wrong purposes. The Theory of Relativity, after all, was the inspiration for the development of the atomic bomb.
I do not, however think - like some - that Truvada is the equivalent of a nuclear disaster.
I think instead, that - like Einstein's theories, and the discovery of the pill - the truth about Truvada is radical and essential information that needs to be widely disseminated, because of the possibility it has for improving all our lives.
So please - speak, email, sing, shout - and tweet - the news!
Sure, condom usage has drastically reduced the transmission of HIV and death from AIDS — but we now have another incredibly effective tool to add to the arsenal. And that knowledge has the enormous power to free us from fear.