Truvada Whore: The War Escalates With AHF’s Anti-PrEP Campaign

"I think AHF has become the Tea Party of HIV prevention." Adam Zeboski (far right) Truvada advocate

It was 1996. And Michael Lucas had a boyfriend. All was well. Until the boyfriend tested positive for HIV.

“It was fearful. So unpleasant,” Lucas, 42, recalled. “He accused me of giving it to him and we went to get tested and I was negative. Seeing him so desperate, I was scared for him.”

Lucas no longer fears getting the virus because he now takes Truvada and believes that’s enough to protect him from a disease that has taken the lives of so many gay men.

Today he is a famed gay porn director and has become an outspoken advocate for Truvada, which is being touted by many as a way to stop the HIV epidemic.

What is Truvada?

Truvada is a mainstream HIV medicine that is now being used to prevent HIV in what’s called pre-exposure prophylaxis, more commonly known as PrEP. Doctors in the U.S. have used pre-exposure prophylaxis for decades to prevent other diseases such as malaria in American’s traveling abroad.

The drug has been around for about a decade and is produced by California-based Gilead Sciences. It’s one of the key drugs used (in combination with others) in the basic treatment for HIV.

The Food and Drug Administration approved Truvada for PrEP on July 16, 2012. In May of this year the U.S. Public Health Service (the agency in charge of the Centers for Disease Control) released the first comprehensive clinical practice guidelines for PrEP recommending pre-exposure prophylaxis with Truvada to be given to high infection risk populations.

“This is another great tool against HIV,” said Jack Mackenroth, a celebrity HIV activist. “We have a drug that’s proven to prevent HIV transmission so why isn’t everyone taking it?”

Mackenroth has been taking Truvada for 7 years — for treatment of his HIV, not prevention.

Some have argued that the long-term side effects of Truvada are unknown, another reason to not take the drug. Mackenroth said: “I haven’t had any side effects. You know what does have side effects though? HIV.”


This chart was created in response to AHF's anti-PrEP print campaign, which can be found on page 20 of this week's newspaper.

PrEP Vs. Condoms

Controversy over PrEP, and its effectiveness, continues to persist with the AIDS Healthcare Foundation being the drug’s most outspoken opponent.

AHF recently doubled down on their anti-PrEP efforts releasing a print ad campaign called “PrEP Facts” claiming “there is a major debate going on about the efficacy of the drug Truvada to prevent HIV.” The rest of the ad disputes Truvada’s effectiveness as a preventative measure. The ad mostly attacks the adherence part of the clinical trials saying “low adherence means low effectiveness in preventing HIV.”

As for Truvada’s actual effectiveness the CDC states that in terms of gay and bisexual men: “those who were given PrEP were 44 percent less likely overall to get HIV than those who were given a placebo. Among the men with detectable levels of medicine in their blood (meaning they had taken the pill consistently), PrEP reduced the risk of infection by as much as 92 percent.”

AHF though continues to promote condom use as the primary way to stop new HIV infections. They recently caused a furor in Fort Lauderale with a racy billboard showing an unrolled condom with the words “Why Worry,” and pointing to their website UseACondom.com.

No one disputes that low adherence to Truvada dramatically decreases its effectiveness though. However, some supporters of PrEP say that AHF should focus their efforts on promoting adherence, rather than campaigning against the drug altogether.

“The irony of AHF’s promotion of condoms cannot be ignored in this debate either. We know that condom use, when used every single time is about 70 percent in anal sex, but we also know only 1 in 6 MSM [Men who have sex with men] are using condoms 100 percent of the time,” said Todd Heywood, a veteran journalist who reports on HIV policy issues for many publications. “That failure to achieve 100 percent adherence to condom use means there a zero sum gain when it comes to prevention — basically a 50/50 roll of the dice. So, explain to me why condom adherence issues have not led AHF to declare war on condoms only messaging?”


"We have a drug that's proven to prevent HIV transmission so why isn't everyone taking it?" Jack Mackenroth, celebrity HIV activist

In Heywood’s statement above he’s referring to a study released by the CDC in 2013 that found condoms only stop seven out of ten HIV transmissions via anal sex – the same efficacy found by a 1989 study.

That means condoms were only effective 70 percent in men who claimed they used condoms 100 percent of the time. Furthermore the study found long-term 100 percent condom use is a minority behavior. Only one-in-six gay men actually managed to maintain it over the three to four year time frame of the analysis.

“If something comes along that’s better than condoms, I’m all for it, but Truvada is not that,” said Michael Weinstein, president of the AHF, in an interview with the Associated Press. “Let’s be honest: It’s a party drug.”

Supporters of PrEP believe that Weinstein is trying to shame people into not using the drug.

“I do, however, see a disturbing trend in the Truvada Wars,” Heywood said. “The defeatist rhetoric and sex shaming are appalling. But the surrender to barriers simply does not comport with the history of fighting this epidemic. The fight against HIV has always been about dismantling barriers.”

Heywood does agree with AHF that adherence is a problem but is one of the people who believe the organization should be tackling the problem rather than giving up and staging an all war again the drug.

“I concur that there should be some level of concern about adherence rates for PrEP,” Heywood said. “I think we should be asking how do we improve adherence and access, rather than allowing misguiding, misinformation campaigns to guide the conversation.”

Heywood isn’t the only HIV activist that is furious over the AHF campaign.

“Their campaign does not contain facts. They have taken the worst study results from the earliest trials and presented them as facts. Early trials included, for instance, those who did not choose to take the drug as part of the percentage of those for whom the drug was ineffective,” said Mark S. King, an HIV activist and author of the popular HIV blog, My Fabulous Disease. “To present this data as fact isn’t just dishonest; it’s a disgrace to our community and to those who care about HIV prevention. While thoughtful people are welcome to discuss the relative value of using a medication to prevent HIV infection, AHF is using deception and misinformation.”

The Rise of the Truvada Whores

In 2012 David Duran, a popular columnist, who routinely covers LGBT and HIV issues, coined the term “Truvada Whore” to describe gay men who wanted to take the drug to prevent HIV.

He was skeptical it was going to work and believed it may create a new generation of sluts and encourage unsafe behavior.

His Truvada Whore comment sparked a contentious debate over whether the drug would encourage unsafe behavior. On the flip side his comments also launched a social media movement #TruvadaWhore that seeks to embrace the name rather than run from it.

Adam Zeboski, 26, launched his own Truvada Whore campaign in February as a way to reclaim phrase. So far he’s sold 450 t-shirts with the Truvada Whore branding.

“I saw the Truvada Whore label start to gain popularity in the social media world and then we started seeing it pop up on hook up apps like Grindr and Scruff. Some people though used the term in a derogatory way towards people who use PrEP,” he said. “I wanted to take that term and transform it, and reclaim it, like the gay community has done with queer and dyke. Now people are using it as a term of endearment.”

Zeboski, who lives in San Francisco, said he’s proud to be a “Truvada Whore.” He’s been taking the drug sine November of 2012.

“I haven’t had any side effects,” he said. And as for adherence he’s found a way to remember to take it every day. “I have an alarm that goes off every day at 9 a.m. I’ve only missed one or two doses my entire time.”

“I think AHF has become the Tea Party of HIV prevention,” he said. “It really brings down reputation of AHF. They have a lot of money and lawyers and can make things happen with those resources. Regular non-profits don’t have the funding to combat these false advertisements.”

The campaign against PrEP has inspired Zeboski, and others, to become advocates for Truvada. Zeboski hopes to use the Truvada Whore movement to become an educational advocate for PrEP.

Another self-proclaimed Truvada Whore is Wilton Manors resident and pharmacist Robert Shore, 50.

“I am a proud Truvada Whore,” Shore said. “I’m going to take that term and use it positively. It keeps me safe. I even made a temporary tattoo for myself to wear. I got good feedback. And it led to conversations.”


"I know that id every gay man is taking PrEP there will be no HIV virus. It will be the end of HIV. For the first time in my life... I am no longer afriad to get tested." Michael Lucas, gay porn director

For Shore it’s become his personal mission to educate anyone who will listen about the benefits of using Truvada. Like Zeboski he hasn’t suffered from any ongoing side effects — except one.

“I guess having stress relief is a side effect,” he said. “That’s a positive effect.”

Michael Lucas has also become a fierce advocate for Truvada speaking out as much as he can and pursuing opportunities to be interviewed.

“I do this because I care about the community and I want other people to use PrEP as well. Because I know that if every gay man is taking PrEP there will be no HIV virus. It will be the end of HIV,” he said. “It’s been incredible and liberating for me. For the first time in my life, in the last two years, I am no longer afraid to get tested,” When you are on Truvada you have to be tested so I always know my status and I am never worried anymore.”

Lucas said he knows a couple of guys that have tested positive for HIV in the last year who had never heard of PrEP.

“They had no idea. Today a gay man that has no idea about PrEP is scandalous,” he said. “It’s is absolutely preposterous.”

And Lucas is making it his mission to make sure that every gay man knows what PrEP is.

As for David Duran even he has since come around, changing his opinion on the matter writing in an article in March of this year: “I’m not ashamed to say that I might have come off a bit conservative in my thoughts regarding how PrEP is used…but at this point, I am a supporter of anything that will help eliminate future infections.”

The ‘Old’ Pill Faced Similar Criticism

Another preventative medication that still causes controversy more than 50 years after FDA approval is the common birth control pill, simply known as ‘The Pill.’

Supporters of PrEP link their cause and fight to that of the rise of the birth control pill. And just like PrEP there were many opponents to the pill. One such case in 1967 included African-American activists charging Planned Parenthood with committing genocide when they started distributing the pill in poor, minority neighborhoods.

A year later in 1968 Pope Paul VI officially declared his opposition to the pill despite his own commission’s recommendation that that these contraceptives were not “intrinsically evil and that Catholic couples should be allowed to decide for themselves about the methods to be employed.”

And just like today where some say PrEP will turn all gay men into whores, many believed that the pill would do the same to women. Some even blamed the sexual revolution of the 1960s and 70s on the pill.

What really links the two issues together though is adherence, which is key to the effectiveness of the birth control pill. Opponents question whether gay men can take a pill everyday.

“How come we believe women can prevent pregnancy by taking a birth control pill, but somehow gay men would be too incompetent to be able to take a pill as well?” Shore said.

The stakes are arguably a lot higher when it comes to an HIV infection versus a pregnancy.

“Having HIV is a lifelong infection,” Shore noted. “I want to do everything I can to prevent that state of health.”

Putting PrEP Into Action

A few months ago Shore participated in a panel discussion on PrEP at the Pride Center at Equality Park in Wilton Manors. It was then he realized there needed to be something more, something ongoing.

And so he founded a PrEP discussion group that has so far met a few times with 15 people attending the first one. For now there is no regularly scheduled meeting days or times.

Shore said he once strictly adhered to using condoms, but at some point he noticed his sexual behavior changed, and that’s what prompted him to seek out another form of protection.

Tim Haymon, 50, of Oakland Park is a co-founder of the above-mentioned PrEP group. Ever since he learned of PrEP he’s also become a vocal advocate.

“I do have to explain what PrEP is to a lot of people and that’s why I wanted to be interviewed,” he said. “So many people in South Florida that says no I never heard of that. It’s just shocking to me that there’s such a large percentage of gay people here yet so little information out there.”

Haymon admitted Truvada has changed his sexual behavior — he isn’t as concerned with using a condom as he once was. As for adherence that hasn’t been an issue.

“It may just be my age, but I have other pills I have to take on a daily basis that I’ve been taking for years. I never forget to do it,” he said. “I have a routine and I just added this my routine.”

Shore added: “I’ve maybe missed one dose.”

As for the discussion group Haymon said, “we’re still not clear what our goals are. I see it as a great companion to the town hall meetings that they’re having at the Pride Center.”

The Pride Center is holding its second town hall meeting on PrEP on Monday, October 6 from 6:30 p.m. to 8:30 p.m. The first one focused on the research into PrEP while this one’s title is “Putting PrEP into Action.” And it will answer questions like “what are people’s experience locally with PrEP,” “who is prescribing it,” “how do I decide if I should take it,” and “how do I pay for it.”

Shore goes on to insist he isn’t against condoms. Most importantly this is about education. “I advocate information. You need to make it your own decisions,” he said. “I’m happy to use a condom — let’s have fun. But that’s for your protection though not mine.”

The new guidelines for PrEP

1. Provide clear criteria for determining a person’s HIV risk and indications for PrEP use.

2. Require that patients receive HIV testing to confirm negative status before starting PrEP.

3. Underscore importance of counseling about adherence and HIV risk reduction, including encouraging condom use for additional protection.

4. Recommend regular monitoring of HIV infection status, side effects, adherence, and sexual or injection risk behaviors.

5. Include a providers’ supplement Adobe PDF file with additional materials and tools for use when prescribing PrEP.

The new federal guidelines recommend that PrEP be considered for people who are HIV-negative and at substantial risk for HIV.

For sexual transmission, this includes anyone who is in an ongoing relationship with an HIV-positive partner. It also includes anyone who:

  1. Is not in a mutually monogamous* relationship with a partner who recently tested HIV-negative
  2. is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the past 6 months; or heterosexual manor woman who does not regularly use condoms during sex with partners of unknown HIV status who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners).

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