On the lawn of a waterfront million dollar home in Hollywood a HIV prevention group gathered to talk about sex. The panel discussion, organized by Impulse Group South Florida, featured physicians, health care lobbyists and social workers – all on hand to speak about the controversial issue of pre-exposure prophylaxis or what is commonly referred to as “PrEP.”
“PrEP has become a major topic in our community,” said Impulse Group South Florida President A.J. Alegria. “We see a lot of opinions, a lot of debate about whether it’s the right thing to do socially and medically.”
Alegria, who moderated the panel, said Impulse Group, an outreach arm of the AIDS Healthcare Foundation, was neither for or against PrEP, but by hosting this event, was seeking to educate the sexually active South Florida community.
PrEP involves taking a pill called Truvada in order to prevent being infected with the HIV virus. Panelists discussed those taking the medication, which some in the gay community have labeled “Truvada Whores,” as well as a number of topics involving men who have sex with men.
The panel included Kishi Martin, a community outreach educator for Care Resources, Inc.; Mike Williams, a medical doctor completing his internal medicine residency at Mount Sinai Hospital; Steven Santiago, a medical doctor for Care Resources, Inc. and Jason King, manager of advocacy affairs for the AIDS Healthcare Foundation Southern Bureau.
King described PrEP as “another tool in the tool box” for patients who want to mitigate the risk of contracting HIV. Truvada, King said, is a drug made by Gilead Sciences, Inc. and is widely prescribed in North America.
Santiago said Truvada is prescribed for “high risk individuals” and must come with counseling from a health care provider. Care Resources, Inc., South Florida’s largest and oldest HIV/AIDS service organization, has endorsed PrEP as a treatment option.
Before the panel discussion, young men drank mimosas poolside while others mingled inside the house. Those attending were asked to complete a survey of questions of their sexual habits and HIV status.
Panelists often cited statistics from various agencies, including the Centers for Disease Control, which has endorsed PrEP as a prevention method against HIV, but King stated believing statistics is another story.
“All of these statistics are based on self reporting and self reporting is notoriously unreliable,” King said.
King was also skeptical of the counseling requirement that comes with a Truvada prescription.
“In the real world, people do not go to frequent counseling,” King said.
As an alternative to Truvada, Williams stated Stribild is also being prescribed for PrEP purposes.
The Food and Drug Administration has yet to approve Stribild as a treatment for PrEP and Santiago noted the risk for recreational drug users taking Stribild as well.
“The problem with Stribild is since it has a booster that can create problems for someone who uses crystal meth or ecstasy,” Santiago said. “It can increase the drug’s effect and become pretty dangerous.”
The discussion went on for almost two hours and jumped from topics such as adherence, to access to self-esteem. Williams said there are clinical studies on-going examining if less than a once-a-day dose of Truvada will still be as effective. Early results point in that direction.
“This is a backup plan,” Williams said of PrEP. “This should not be taken as a primary method of preventing HIV.”
Williams also said there is a whole “laundry list” of diseases one could catch that PrEP is not able to prevent.
Martin, who is HIV negative, stressed the importance of getting tested regularly and to take greater control of safe sex practices.
“Whenever you are having sex you have to do what works for you,” Martin said. “But at the same time you have to be comfortable enough to assert protection and get tested and be confident and comfortable enough to stand by that choice.”