101 -- An Intensive," 1997|
Visual AIDS has asked community members to share their thoughts through blog posts on the recent FDA decisions, recommending the approval of Truvada as a form of PrEP, and the sale of Oraquick’s rapid, over the counter, take-home HIV tests. Through these blog posts, we hope to encourage conversation around these current events, and inspire artists, writers, and others to consider what is going on right now in terms of HIV/AIDS. For more information, please view the links below.
Mark "middle" Hubbard: The realization I've come to after being immersed in PrEP conversations for about four years, is that we must recognize and honor that Truvada for PrEP is a first-generation technology. Think of brick-sized cell phones and forty-pound, "portable" personal computers. It's clunky, costly, has some downsides, and is highly dependent on user motivation for successful use.
Think also of early HIV treatment regimens, which had the same characteristics. As was the case back then, this first generation intervention is appropriate for those who need it most (like I needed my Crixivan / AZT based regimen in 1996.) Folks whose risk is moderate might be better served by re visiting and working on using existing methods, such as condoms.
The prevention pipeline is rich with potential second and third-generation possibilities, including long-acting injections (which would minimize the adherence factor), the search for drugs not intended for treatment (and therefore less of a concern with regard to resistance), and, of course, microbicides and other technologies like vaginal rings and films, and augmented receptive condoms and diaphragms.
I'm absolutely pro-FDA approval and for making new tools available. That being said, folks need to understand that Truvada isn't appropriate for folks who have chronic Hepatitis B and that prevention is much more than a pill. It needs to include a lot of other components such as frequent HIV & STI & metabolic testing, adherence support and risk reduction guidance. I think we should both fiercely advocate for access to competently and sensitively provided Truvada for PrEP, while insisting that the search for second and third-generation prevention technologies doesn’t languish in research. We must also advocate for an effective vaccine, better treatments, and ultimately, a cure.
"Blue in the Face II," 2007
Mark "middle" Hubbard is an HIV treatment and prevention research geek, queer health advocate, radical faerie, writer and activist who has been living with HIV for 25 of his 50 years.
If you have any questions, comments, or would like to share your own reactions please email us at email@example.com