AHF President Michael Weinstein Spurs Outrage with Remarks on Truvada: ‘It’s A Party Drug’

Michael Weinstein

Slowly but steadily Truvada as PrEP is gaining awareness and acceptance as a valid method for preventing HIV transmission. The drug's reputation is not without its problems, however, including no small number of myths and misinformation that routinely have to be debunked. Adding to the opposition of the drug's uptake is AIDS Healthcare Foundation President Michael Weinstein.

Said Weinstein of the drug: Truvada

If something comes along that's better than condoms, I'm all for it, but Truvada is not that. Let's be honest: It's a party drug.

Weinstein received immediate public backlash and condemnation for the remarks.

Mr. L.A. Leather Eric Paul Leue pulled no punches on his Facebook page (some content hidden depending on privacy settings),

I speak out against Weinstein's ignorant form of speech that is attacking our LGBT community and those that are aware[…]He disgraces those that are actively seeking protection, awareness and knowledge by literally calling them drug addicts.

Adult video producer Michael Lucas called for Weinstein's removal as AHF president:

In this man’s prurient imagination, gays are too busy enjoying their bareback orgies to be trusted with taking a once-daily pill. In his view, gay men using PrEP will stir up a frothy new drug-resistant strain of the virus. What evidence exists that this is a valid scientific concern? None. He has not even credited the fact that this form of prevention might and is being used by responsible gay men regardless of the sexual activity they are engaged in. Mr. Weinstein’s anti-PrEP position is an extension of his long-standing anti-promiscuity crusade and more importantly his continuation of harmful shame tactics.

The facts are that Truvada is estimated to be over 99% effective when taken properly. Additionally, the fear that Truvada will encourage riskier behavior is not founded in fact; men are already having condomless sex regardless of the availability of PrEP, and during the iPrEX studies prior to FDA approval there was no increase in risky behavior between the men who thought they were on PrEP versus those who thought they were on the placebo.

Comments

  1. Kipp says

    The study which claims to “prove” that Truvada therapy does not lead to increased risky behavior does nothing of the kind. The people involved in the study knew that they were getting either Truvada or a placebo – that is, they knew they might not be on a protective drug at all. Non-trial users of Truvada know they are taking a protective drug – it wouldn’t be a urprise if they actually start acting like it. We simply don’t have conclusive data on whether Truvada use causes a net increase in risk or not.

  2. theo says

    It isn’t a “party drug,” but protection from HIV does not equal protection from a myriad number of STDs (gonorrhea, herpes, etc), nor does it protect you from whatever comes NEXT.

    As diseases become antibiotic resistant and bareback sex increases (not tied directly to usage of Truvada, but of trends in the community-at-large), the gay community IS risking another catastrophic, untreatable disease or virus. It is not a matter of if, it’s a matter of when.

    For me, I’ll keep wrapping it up.

  3. Bill S. says

    If the best rebuttal you can find comes from a porn producer and Mr. L.A. Leather, then the guy might have a point.

    Truvada’s 99% effective against HIV? That’s nice. Is it effective against Herpes? HPV? Will it be effective against the next undiscovered virus or STD that’s lurking out there?

  4. RandySF says

    @KIPP – the study tried to determine who thought they had the actual drug and analyzed their behavior. In general, though, the same argument that you’re applying has been launched against condoms, sexual education, and the HPV vaccine. It has no merit.

    @THEO – Good for you for using condoms, but can I ask you… why not both? If condoms work for you, you should realize that they aren’t 100% effective. In actual typical use they’re something like 80% effective. Truvada is much more effective at preventing HIV than condoms are.

    Also, I strongly disagree with the argument that condoms prevent STDs other than HIV so Truvada is bad. Condomed sex typical use is condom for anal sex but no condom for oral sex. Virtually every STD out there is easily transmitted through oral sex with the exception of HIV. We, in general, consider condomless oral sex (swallowing included) to be relatively safe despite the fact that it spreads STDs easily. So why shouldn’t we consider any protection from HIV (the one thing we’re really protecting from with condoms) to be protection?

  5. jonnathewoodswoman says

    Truvada use causes permanent kidney damage. Use condoms and you’ll be fine. This seems pointless promotion of a drug which will damage you, permanently.

  6. lucas says

    As a PrEP user I am always stunned at the stigma that people put on it.

    Personally, I always use a condom when I have sex (except sometimes when in a relationship). What PrEP does for me is offer an extra measure of protection in the case of unforeseen circumstances (broken condom, cheating partner, etc.)

    Why denigrate what is ultimately another very effective tool in our arsenal to prevent HIV infection?

  7. lucas says

    @JONNATHEWOODSWOMAN – While it’s true that kidney damage is a possible side effect, it isn’t one I’ve encountered myself – at least so far. If it does become a concern, I can always stop PrEP.

    Most drugs can have harmful side effects. Acetaminophen can also cause kidney damage, but do most people avoid Tylenol?

  8. 24play says

    Thank you, RandySF, for valiantly (and, probably, vainly) trying to keep this a fact-based discussion about HIV prevention methods and how they work in the real world. I can’t imagine you’ll get much traction among the pearl-clutching folk who can’t seem to adjust to a world in which condoms are just one of three highly effective prevention regimens and the choice of which regimen (or regimens) is best is a decision that can only be made within the context of an individual’s own sex life, risk aversion, health profile, and behavioral history.

  9. DBAUDIT says

    Weinstein’s greatest fear is that there will be a fool proof preventative or a cure and then he will be out of a job! If he had his way we would all have taken vows and be living in monasteries in the 80s.

  10. Fred L says

    I’m a Truvada whore. I’m neg (just tested, for the 100th time), and make a $125 monthly co-pay for the other little blue pill. Do I occasionally have riskier (unprotected anal) sex? Sometimes– but rarely. Did my doctor lecture me against this? Yes. Do I realize I’m kind of abusing the very privilege of PrEP? Kinnnda. Do you need to get over your frustration about what I’m doing? Ummmm, yes.

  11. jake john says

    Relax people.. He has a point that those who practice unsafe sex love to ignore.. Aids became an epidemic because of unsafe sexual behavior.. Using Truvada in order to have unprotected sex DOES leave open the possibility of yet another major virus to rip through the gay community as it did in the 80s and 90s. Also, Truvada doesn’t protect against any other STD which also leaves the door open for another outbreak.. Why the POZ community is leveraging their power to try and debunk common sense is beyond me, but it’s starting to make us look like a bunch of wackos who refuse to take responsibility for their actions.

  12. Kipp says

    @RandySF

    I am criticizing the attempt to claim than any study has proven Truvada doesn’t lead to riskier behavior. I am not arguing against the merits of Truvada use. I’m all-for another prevention method. Truvada doesn’t change human nature, however, and as commenter Fred L exemplifies, people will do riskier things when they think they are protected. An honest defense of Truvada would aknowledge the possible increase in riskier behavior – and weigh that fairly against the real protection the drug provides.

  13. WTF21 says

    I just do not understand why the hell Michael Lucas thinks his opinion is worth anything. Moreover, why the hell would anyone listen to anything Michael Lucas has to say?

  14. BIll says

    I can think of about 13,000 reasons not to use it for prevention, but as more people do those “reasons” (the yearly cost in dollars) should drop to much closer to the manufacturing cost, barring anti-trust issues.

    It could be a cost-saver, particularly if provided to sexually active people in their early twenties who will eventually settle down, by preventing a lifetime need (or use until there is a cure) for an expensive drug.

    I’m not sure what people are arguing about other than cost – if you have two independent but not 100% reliable preventive measures, the obvious strategy for self preservation is to use both. That’s “risk management 101″.

  15. Harrison says

    This might be Medicine 101 here, so my apologies if I’m dumbing down the comments thread.

    The summary of the iPrEX study mentions that all the participants received condoms and that participants reported an increase in condom use over the duration of the study. So aren’t the “99% protection against HIV” and other good-sounding statistics at least partially due to people who were using condoms?

    Perhaps there are other things that I should be reading but, unless there was a study that only included people ONLY taking Truvada (with no other safer sex practices), and compared their outcomes to people not doing anything at all, I don’t see how they can draw the conclusion that Truvada is “more effective” than using condoms.

    Maybe it’s just in the way people are phrasing their comments — the only comparison example I can come up with, and it’s awful, is that it’s like saying “wearing a jacket is more likely to keep you warm than wearing a sweater… even though some people were wearing a sweater under their jacket too.”

  16. enchantra says

    Truvada doesn’t protect you from hepatitis does it?

    Everyone talks about the AIDS epidemic like that was the whole of the problem. No, it wasn’t. The problem was the meth, coke, IV drug use, insane lifestyle, round the clock weekends (or weekdays), and general wear and tear on our bodies. I know, because I was there. The amazing thing isn’t how many of us are dead, it’s how many of us are alive.

  17. 24play says

    Harrison,

    It would be unethical to run a trial of a PrEP drug that did not include condom availability for all participants. You can’t ethically withhold an effective preventative.

    That being said, you’re correct, condom use no doubt plays some role in the statistics for the efficacy of PrEP. Similarly, pulling out before orgasm probably plays some role in the efficacy rate for condoms alone. Still, no person has ever been shown to become HIV positive while taking Truvada as PrEP as directed, and even among those who are not terribly adherent to the daily schedule of PrEP dosing, Truvada appears to have a 40% to 60% effectiveness rate.

    So, in a world where we know condom use among gay men has declined precipitously (in response to HIV/AIDS being much less frightening), PrEP makes sense as a preventative measure for many people. People who don’t have a great record of using condoms, people who have substance abuse issues, people who are very sexually active, and HIV– people who are in relationships with people who are HIV+ are just a few groups of people for whom PrEP — with or without other interventions — might make good sense as a preventative based on their particular susceptibility to side effects, ability to pay for the drug, willingness to show up for quarterly monitoring with their doctor, risk aversion, history of sexual behavior, likelihood to adhere to daily (or near daly) dosing, etc.

    There is no longer any one “right way” to prevent HIV infection. We have several methods from which to choose in each individual case.

  18. Bill says

    @Harrison: the way you draw conclusions when you don’t have one group that uses only Truvada is by using a multivariate analysis.

    That sort of analysis (there are several, actually) can be used when you can’t dictate people’s behavior.

    For example, it would be ethically dubious to ask people to have unprotected anal sex in order to measure the HIV transmission rate, but some people do that on their own (not necessarily 100% of the time) and you can ethically ask them how often they use a condom.

  19. Buckie says

    The drug combo Truvada makes sense for some people.

    But at 13k a year, the long-term effects – which have been downplayed, and the potential for adverse reactions, drug interactions, side effects, and lack of effectiveness due to missed doses, presenting it as anything but a treatment appropriate for a small percentage of gay people is irresponsible.

    I’m sure the company that manufacturers it is very happy at all the free PR/controversy, which is also manufactured, on a weekly basis.

  20. ToddKnows says

    If the party drug crowd is embracing it, which comes as no surprise, as that’s who it’s been marketed to, then it’s not outrageous to observe that it’s being used that way.

    I’m not interested in what Mr. LA Leather has to say, or what some pornographer thinks.

    They protest a bit TOO much.

  21. Frank says

    I don’t know anyone that would take Truvada.

    But my friends behave like adults; they don’t have sex with people they don’t know, and they take their health seriously.

    I’m not saying that the kind of people that take Truvada are bad people, just not the kind of people I’m interested in having sex with.

    I worked at a porn company years ago, and I know what it’s all about. Collecting STD’s and taking a lot of prescription and illicit drugs isn’t the kind of life I’ve ever been interested in. But I can certainly see how Truvada might seem appealing to that particular group of people.

  22. Tom in Lazybrook says

    Lets not pretend that Truvada is being used to REPLACE condoms. Truvada could be marketed as being used with condoms. But that’s not happening.

    We need some MORE stigma. Directed at the bareback/meth/same thing crowd that put our entire community’s health at risk.

    If you bareback, I have the following message:

    I don’t care how much chemo you put in your body. That doesn’t give you a moral right to put your own, your partner’s and our community’s health at risk becuase you are nothing more than a selfish whore who puts you sexual gratification above all else.

  23. Marc says

    As of April 15, 2014, this is what we have available to us to help prevent disease. Yes, I’m sure the future is filled with pills and cures. In the meantime, we do what we can to protect ourselves and our partners. It’s a shame to have the President of the AHF pulling the same “stigma” card that the anti-gay crowd has pulled on us for years. Enough already. As long as we inform people what Truvada prevents AND does NOT prevent, people will hopefully make better choices.

    Stop the shame, AHF. Except the shame on you.

  24. andy says

    ” no increase in risky behavior between the men who thought they were on PrEP versus those who thought they were on the placebo.”
    BECAUSE THOSE SELECTED VOLUNTEERS ALREADY NOT USING CONDOMS! It couldn’t get riskier!I’m so sick of these press releases being passed off as news. Why didn’t you include the fact that Gilead was found guilty of colluding with the FDA to get favorable results? Or that they can’t even get half of the participants to adhere? Just be honest and put “a paid advertisement from Gilead” on this.

  25. Liam says

    I just throw up my hands over this discussion and Michael Lucas’ comments. Seriously everyone stop being so judgemental about other peoples behaviors. How about we each worry about our own behavior and stop associating everyone else with the worst interpretation of every situation? If Truvada stops people from getting infected then great. Let them take it. They are adults. It is no business of yours whether they take it or not. It is between them, their doctors and their sexual partners if they decide to have unprotected sex. Maybe this is a godsend for men who are incredibly nervous about having any sex. It can give them added piece of mind know they have another layer of protection in case something goes wrong or they get carried away and do something stupid. And who has not done something stupid once or twice in their lives.

  26. Jay says

    It seems to me that waiting 20 minutes and testing for HIV (with Oraquick or similar home HIV test) is less risky and taxing on the body than subjecting in to a drug.

  27. says

    Michael Weinstein needs to be removed from AIDS Healthcare Foundation (AHF). He has proven he is unfit to lead that organization. I simply can’t support an organization that would let a man like him remain in that position.

  28. says

    Michael Weinstein did not say anything that hadn’t already been said over the past several years. For some, Truvada was a party drug (for barebacking) before PrEP was approved by the FDA; Truvada made available by HIV+ individuals and available for sale via Internet with no prescription necessary.

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