Bioethics Blogs

Truvada: No Substitute for Responsible Sex

A new debate is surging through the gay male population in the United States: should gay men take a drug that can reduce their risk of contracting HIV? The drug in question is Truvada, a combination antiretroviral commonly used to treat HIV infection. In 2012, Truvada was approved by the U.S. Food and Drug Administration as the first drug to be used for pre-exposure prophylaxis in the longstanding battle against HIV.

 The availability of Truvada as a prevention tool has led to some positing that it could be the “new condom” for gay men, while others have voiced concern that the drug will be used improperly or will only exacerbate rising rates of unsafe sex among gay men. But what is currently missing is a frank discussion about personal responsibility in gay men’s sexual health choices, and the duties all of us have, not only to ourselves, but also to our partners and the gay community as a whole.

There is no doubt that Truvada has demonstrated its potential for success. In a clinical trial examining the drug’s effectiveness in transgender women and men who have sex with men, researchers found that Truvada, on average, was effective in reducing HIV transmission by 44 percent. For those study participants who adhered to the daily regimen of the drug and had detectable levels of the medication in their blood, the protective effect of high adherence was over 90 percent. Whether the participant was on a placebo or the study drug, treatment was provided with a comprehensive package of prevention services, including monthly HIV testing, risk-reduction counseling, condoms, and the diagnosis and treatment of other sexually transmitted diseases.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.