NL- Interesting commentary. Well done articles. I’m really happy to have been introduced to Sayen CroWolf of http://sayencrowolf.net/
OP/ED by Sayen CroWolf
The AIDS Health Foundation, led by Michael Weinstein continue their attack on PrEP and Truvada in an article posted in today’s Chelsea Now. It’s a very well written article, and I’m going to weigh in as necessary throughout it:
While medical professionals and advocacy groups have begun to promote the research and development of pre-exposure prophylaxis (PrEP) as a method of HIV prevention for gay men, the AIDS Healthcare Foundation (AHF) has created a stir with its nationwide media campaign bent on stopping federal approval of PrEP. The campaign’s primary target is the drug Truvada — manufactured by Gilead Sciences (a California-based company that creates antiretroviral drugs used for treatment of HIV-positive patients).
“As a gay man, I believe this would be a catastrophe for HIV prevention,” said AHF President Michael Weinstein in an August 3 phone interview. “The drug companies are not our friends, and I just don’t think that they, the government or the academics involved in PrEP studies can claim to understand the gay community better than any gay man does.”
Weinstein’s quote is probably the most dangerous thing I’ve seen him say. He’s not mounting a campaign against Truvada because there’s solid factual evidence, he’s doing so because he thinks it’s a bad idea. He knows what’s best for the gay community. Um, says who? This is the same man who insisted – via his position with the AHF that Viagra promoted a party use atmosphere. No, I’m totally serious. But, let’s keep going shall we?
Weinstein and other members of the campaign often invoke the 44 percent efficacy results of last year’s iPrEx study (which enrolled 2,499 participants to test Truvada’s ability to prevent seroconversion in at-risk, HIV-negative gay men), as well as low adherence rates and thoughts that no clinical PrEP research will translate into real world success for sexually active gay men.
“If this pill were approved by the FDA,” Weinstein added, “why would those men bother to keep wearing condoms?”
Two strikes here: Weinstein keeps inaccurately stating the results of iPrEx so let’s clear that up with this:
The iPrEx study reported its initial findings in November 2010. It found at this point that the overall efficacy of the drug in preventing HIV was 44%, in other words that nine HIV infections out of 20 that would otherwise have happened were prevented.
Updated findings, presented at the International AIDS Society conference (IAS 2011) in Rome by the trial’s lead investigator Robert Grant, show that the finally-calculated overall efficacy was 42%. There were 131 HIV infections during the study, 83 in the placebo arm of the 2499-member trial and 48 in the Truvada arm. The 95% confidence interval was 18% to 60%, meaning that the ‘true’ efficacy, allowing for chance, had a 95% chance of lying within these figures. The probability that the finding was a chance one was 0.002, meaning there was only a one in 500 chance that the efficacy observed was purely due to chance.
and let’s answer his question with the results of his very own PrEP study. 83% of the people they surveyed said they would continue to use condoms for anal sex while on PrEP. Apparently Mr. Weinstein has a short memory or never bothered to read his own survey.
Just for fun, let’s finish off his question with the results of another survey which found that respondents had no intentions of changing their risk behaviours if on PrEP:
Approximately 50% of gay men said they were likely to use pre-exposure prophylaxis (PrEP), but few reported that it would lead to a change in their risk behaviour, according to data presented to the International AIDS Society conference in Rome.
Let’s just finally say it out loud, shall we? The objections AHF and Mr. Weinstein continue to raise and stomp their feet over have nothing to do with fact. They have everything to do with Weinstein’s preconceived and ill-informed notions. Just like his Viagra “red flag”. When he finally realizes that nobody’s listening, maybe all this ambient noise his “No Magic Pills” bit will go away and we can continue to have educated debates on the subject.
Sorry, AHF. I’m still not going to buy what you’re selling.