VAC/GMHC RESPONSE TO NEW YORK TIMES ARTICLE*

In response to the New York Times article “Advocating Pill, U.S. Signals Shift to Prevent
AIDS” (Published 14 May 2014), VAC/GMHC applauds the US government’s foresight in
approving Pre-Exposure Prophylaxis (PrEP). PrEP reduces the risk of acquiring HIV by up
to 99% when taken daily.
Guidelines on how to administer PrEP, recently released by the US Centre for Disease
Control (CDC), recommends PrEP for people in serodifferent relationships, and gay men
who have had condomless sex, or an STI, in the last six months. VAC CEO Simon Ruth
supports these recommendations as they are consistent with VAC’s position on PrEP. He
said, “VAC sees PrEP as an exciting initiative that provides gay men, and men who have sex
with men, who are unable to consistently use condoms - for whatever reason - to have the
same access to HIV risk reduction strategies as those men who consistently use condoms. If
PrEP is administered on this basis, there is an impetus for greater use of PrEP in Australia.”
Mr Ruth further states, “We have also known that there is a group of men who cannot always
use condoms. For the first time in the epidemic’s history, PrEP is a highly effective risk
reduction strategy that gives people at high risk of HIV the opportunity to avoid acquiring the
virus.”
PrEP should be seen as a strategy that provides people at high risk of HIV with an
opportunity to take control of their health and wellbeing in ways that were not previously
available. While the article correctly points out that condomless sex increases the risk of
being diagnosed with STIs, one of the conditions of being on PrEP is regular HIV and STI
testing. This condition means that people on PrEP will be, potentially, screened for HIV and
STIs more regularly than if they were not on PrEP.
The NY Times article refers to health officials saying that PrEP will lead to increased
condomless sex. Mr Ruth said, “This assertion is unsubstantiated, and in the three major
global studies on PrEP, there was no evidence that participants’ sexual behaviours changed
as a consequence of being on PrEP.” In relation to the impact of Truvada on an individual,
Mr Ruth said that, “The side effects of Truvada are limited to mild nausea and constipation,
and in very rare cases kidney damage can result from using the drug. However, as PrEP is
only a short term measure, any tangible side effects disappear very quickly. ” Mr Ruth
welcomed the Victorian Government’s support of a demonstration project investigating the
feasibility of administering PrEP. However, he is very disappointed that Gilead, who
manufactures Truvada, has not applied to the Therapeutic Goods Administration to obtain
approval for PrEP in Australia and that the Australian government is not more actively involved in ensuring that this highly effective HIV prevention strategy is made available to
people at high risk of HIV in Australia. Mr Ruth called on both Gilead and the
Commonwealth to get behind HIV prevention in Australia by immediately entering into
discussions to get PrEP onto the market in Australia as soon as possible and as cheaply as
possible.