Anti-PrEP hysteria is hitting new lows, with attempts to frighten early adopters of Truvada PrEP, the pill that is highly effective at blocking HIV infections. In what almost became a story in The New York Times, someone used the new and highly popular social media app called "Secret" to freak out its many gay users. He claimed that after using PrEP every day for over six months, he had just tested positive for HIV, and he included lots of specifics about his testing history and current doctor visits.
"Secret" is an app that allows users to anonymously post and comment on anything, kind of like Facebook stripped of actual usernames. This particular "secret" quickly generated over 100 comments, like "how is that possible," "bullshit," and "I'm on PrEP too, so I hope this isn't true." He was peppered with many worried questions, and answered them in detail over the next few days. Alas, one of those details made the entire story hard to believe. Two days after getting the news, he supposedly returned to his doc for follow-up test results, and was told he'd been "infected with a non wild strain ... resistant to Tenofovir and Emtricitabine" (the two anti-HIV meds in Truvada).
But here's the rub -- a phenotype or genotype HIV resistance test takes at least one to two weeks before the results come back. Guess he missed that fact when he Googled "Tenofovir and Emtricitabine" (correctly spelled, which would be a first for someone jotting down drug names at a doctor's office).
A few days later, the guy deleted the entire thread, which included inquiries from a Times reporter. Damage done.
Think that's scary? How about the next plague that's coming, or could even be spreading now (right now!) by all those condomless PrEP users? This particular scare tactic is appearing online with increasing frequency. It's based on an unavoidable truth -- mankind will indeed encounter new pathogens that cause disease, even widespread death. When will the next animal virus out there make the leap to humans, and how much damage will its mutations cause? Want to avoid the next plague? Wear condoms!
The problem with this scare tactic is that its prescription doesn't make sense. Until we identify the next deadly pathogen, we won't know which prevention methods work against it. That's why the scientific community preaches heightened detection and reporting as the rational public health response to future pathogens. We have to find them early, and then react quickly. How will a condom prevent a super-virulent swine flu virus? What if the next killer is more like HPV than HIV, and spreads easily via oral sex and vaginal sex?
In other words, why aren't those screaming at gay men to wear condoms to avoid the next plague also insisting that straight people always use condoms? Shouldn't the world quickly set-up test-tube baby clinics, since the standard means of procreation (condomless sex) could spread the next mass killer?
Of course not, and you'll never hear the next-plaguers suggest this. Isn't it interesting that their only prescription is that gay men, and only gay men, need to abandon condomless sex forever? Can you say self-loathing?
As for fighting our current plague, I've said it before, so I'll say it again:
"While the gay men who moralize and finger-wag will most definitely slow us down, AIDS activists and their public health allies will ultimately win this war. So if you're fighting the good fight, and getting any stigmatizing pushback, then push ahead even harder. Give a good smack to that finger in your face, ignore the moralizing idiots online, and find strength from your allies in this fight. And know this -- when this crisis is finally over, there will be two kinds of people remembered: those who fought to end it, and those who slowed us down."