May 27, 2014 | Sex & Society

Is Truvada the Pill of our time?

On May 14, the U.S. Public Health Service released the first comprehensive clinical practice guidelines for HIV Pre-Exposure Prophylaxis (PreP) using Truvada. The New York Times recently speculated that Truvada could have a social impact comparable to that of the birth control pill. 

The debate around Truvada sometimes seems moralistic, but it's  rooted in a fear of change. We've had it hammered into our heads for decades that condoms are the best way to prevent HIV transmission. Now suddenly we're being told that there is a better way, albeit with a hefty price tag and a commitment to taking a daily pill.   

There is also the consideration of an added layer of sexual negotiation, new classes of potential sexual partners and another level of assumptions about the risk to yourself. How many men will lie about being on PreP? Will there be a great divide between men who have the means or the insurance coverage to be on Truvada and those who don't? How many of us will have condomless sex because we start to assume there is a "herd immunity," thanks to Truvada.   

Aside from the cost, there are other negatives compared to condoms. STDs will surely increase when fewer condoms are used and there is a very real risk of treatment-resistant strains of gonorrhea and syphillis cropping up. 

Sex in the age of AIDS has always been complicated. But there should be no more shame in using Truvada to prevent HIV than there is in using the pill to prevent pregnancy. Making Truvada available at a much lower price and adding PreP to the list of anti-AIDS drugs governments will pay for should be a priority for organizations combatting HIV/AIDS.

Are we ready for H.I.V.s' sexual revolution?  [New York Times]