The City of West Hollywood is being asked to take a stand on pre-exposure prophylaxis (PrEP), a controversial approach to HIV prevention.

Truvada
Truvada

The city’s Lesbian and Gay Advisory Board has recommended that West Hollywood require social services agencies with which it has contracts or collaborates to offer HIV testing to provide information about PrEP. The city’s Department of Human Services and Rent Stabilization will ask the Council to send the matter to the Human Services Commission so that it can draft a policy.

The Human Services Department recommendation notes that the city will have to figure out how to include such a mandatory requirement in existing social services contracts, and it notes that L.A. County already is considering a similar move. Many of the agencies with which West Hollywood contracts for HIV testing services work under contracts with Los Angeles County. The county Board of Supervisors last week passed a resolution ” to develop and implement a plan for a “robust, comprehensive program to deliver Pre-Exposure Prophylaxis (PrEP) throughout the County, considering a broad range of medical providers, including the Departments of Public Health and Health Services’ operated clinics as well as community based organizations and clinics, that can effectively provide PrEP to those at high risk for contracting HIV.”

The proposal before the Council doesn’t note that PrEP is the subject of a major debate among gay activists and health care providers. On the one side are organizations such as AIDS Project Los Angeles and the L.A. LGBT Center, which support making Truvada, the medication prescribed as part of the PrEP regimen, more widely available. The Centers for Disease Control also has endorsed PrEP for those at significant risk of contracting HiV because they don’t regularly use condoms, use illicit drugs or are in intimate relationships with HIV positive people. It stresses that PrEP must be combined with consistent use of condoms.

On the other side is AIDS Healthcare Foundation, the world’s largest non-governmental HIV/AIDS service organization, which has said that promoting PrEP will lead a reduction in condom use and thus a higher incidence of other sexually transmitted diseases and that there is evidence that some people on PrEP don’t carefully follow the regimen that requires them to take the Truvada pill daily. Others who have questioned PrEP include Regan Hofmann, an HIV-positive woman who is the former editor of Poz. Hoffman called Truvada, which costs $13,000 a year and is manufactured by Gilead, a  “profit-driven sex toy for rich Westerners.” Dan Savage, the gay columnist, also has questioned whether gay men will use the drug consistently.

The Council will meet at 6:30 p.m. tonight at the City Council Chambers, 625 N. San Vicente Blvd. south of Santa Monica.

9 thoughts on “WeHo City Council Is Asked to Take a Stand on Controversial HIV Prevention Drug”

  1. I’m not sure the City Council’s time isn’t wasted on such an item as this unless it’s to promote, allow or (gawd) restrict some distribution. They have more productive actions to take regarding parking, development, citizens rights, Deputy issues, crosswalk safety and other issues IN our city.

  2. Every major pharma company has been sued for fraud. Data can’t be trusted. PrEP can cause drug resistance if one gets HIV. It’s nothing more than another toxic drug marketed to the misinformed. People on hook up sites talk as if they have nothing to worry about if on PrEP, hence, INCREASING RISKY BEHAVIOR. Research CDC Whistleblower. Almost nothing that comes from CDC can be trusted anymore. Do your research and make your own decision on for-profit only drugs. Some of us are very informed about this drug and it’s toxic implications. Some of us know this is nothing more than another toxic drug to prey on people’s fears. Practice 100 percent safe sex. Condoms and common sense are still the best prevention in my view. Research Emily Newman article on PrEP and Drug Resistance.

  3. TOTAL DEATHS FROM AIDS IN USA 1981-2012: 658,507
    DEATHS FROM AIDS IN USA IN 2012: 13,712
    NEW HIV INFECTIONS PER YEAR IN US: ~50,000
    LIFETIME MEDICAL COSTS FOR EACH NEW INFECTION: $368,000
    LIFETIME MEDICAL COSTS FOR ONE YEAR’S NEW HIV PATIENTS: $18,400,000,000
    AMERICANS CURRENTLY LIVING WITH HIV/AIDS: 1,201,000
    LIFETIME MEDICAL COSTS FOR ALL AMERICANS CURRENTLY LIVING WITH HIV IF THERE IS NO CURE DISCOVERED: $441, 968,000,000
    Right now, only 30% of the 1.2 million Americans with HIV have sufficient access to care and medicine to get their virus low enough to prevent transmission of the virus—which means 70% do not.

    BUT THE GOOD NEWS IS THIS: Though we don’t yet have a cure or a vaccine, we DO FINALLY have the tools we need to stop the spread of HIV…NOW. The only question is whether we can summon the courage to let common sense compel us to muster the political will to do so.

    IF we can muster the political will to provide access to health care for those already in need, access to the medications in PreP/PeP (PROVEN TO STOP TRANSMISSION OF THE VIRUS), access to realistic sex education, access to housing and care; and access to addiction treatment, counseling and needle exchange programs to those carrying the virus or at risk, we can STOP the AIDS epidemic in its tracks NOW. IF we do these things, we will STOP adding 50,000 per year to the 1.2 million already living with HIV—ALL of whom WILL die without access to the life-saving medications that otherwise keep us alive, healthy, and in the workforce as taxpayers until the day there is a cure that is affordable and available to everyone, and an effective, therapeutic vaccine. But we have the tools to turn back the tide…IF we can find the will until the cure and vaccine are developed. To be sure, PreP is not “the” answer. But it IS a useful tool if administered carefully; it is a useful arrow in the quiver of weapons needed to HALT the spread of HIV until the CURE and an effective vaccine are discovered and made widely and affordable available.

    But that can be done ONLY with universal availability of those medications and the stable housing resources necessary to access medical care and counseling to ensure their effective use; with REALISTIC, non-judgmental, age-appropriate sex education that reflects the REALITY of REAL peoples’ lives; the recovery resources necessary to treat those afflicted with the illness of drug addictions; and the availability of legal needle exchanges for persons still living with addiction until their recovery can begin. Because until then we are ALL at risk, directly or indirectly. And we are all in this together, whether we like it or not; whether we choose to acknowledge it or not.

    THIS war is NOT yet won: The enemy is AIDS—not PEOPLE with AIDS.

    No matter how heavy the burdens of “excess taxation” might seem to the “haves” they cannot begin to compare to the burdens of being poor, sick, unemployed or homeless. Abraham Lincoln said that the question “is not whether God is on our side; but rather are we on God’s side?” Ronald Reagan used to say “America is great because America is good.” The only questions that matter in whether we will win against AIDS, and how many more will die are these: Whose side are we on? Are we still that country? And do we have the will to win this before another 50,000 persons contract HIV; before another 658,000 Americans die of AIDS; before it costs our country another several hundred billion dollars?

  4. When someone like Emily Newman, the creator of a marketplace on line for second hand wedding gowns – giving both the original user to recoup some of their investment and newly engaged to save a bundle on a second hand gown. I guess that makes her a qualified expert on the subject of AIDS medications and drug resistance. REALLY??????

    As someone who has taken Truvada since its introduction as part of my medication regimen, and an employee of the LA County Department of Health Services, I can say with confidence that the CDC’s recommended information packet regarding PrEP says quite clearly that intermittant compliance – that is taking the pill sometimes and sometimes not does put one at risk of developing resistance to the drug ONCE YOU HAVE THE VIRUS IN YOU. IT IS THE VIRUS THAT BECOMES DRUG RESISTANT. AND THE CDC QUITE CLEARLY RECOMMENDS THAT THE MEDICATION BE TAKEN ONCE A DAY – EVERY DAY WITHOUT SKIPPING. IT ALSO RECOMMENDS THAT PrEO be taken in addition to wearing a condom. So, ramorey, am I not to believe that? I afraid your comment is quite confusing at best.

    I want to thank Wehoville for re-stating what the supervisors actually voted on.

  5. @ramorey If you’ve actually consulted with a doctor about Prep, you’d understand that they require testing every three months to ensure someone on it doesn’t contract HIV and create a resistant virus. They also test for all other STDs and require a check-in with the doctor about sexual choices, so people on Prep, like myself, actually have a much clearer idea of our risk and our current status across the board.

    I use Prep because like most people I know, I’ve made mistakes. I’m not proud of them and I like to avoid them, but it happens. I’d rather be realistic and have a second round of protection than appease the sanctimonious holier-than-thou crowd like you.

  6. This what I read in the 1st paragraph: “The city’s Lesbian and Gay Advisory Board has recommended that West Hollywood require social services agencies with which it has contracts or collaborates to offer HIV testing to provide information about PrEP.”

    Providing information about a medication to anyone should be something any doctor or health care worker seems a
    given. As in: “Wow! That’s a lot. You are risking an STD – here is information about it and we recommend condoms – the best ones so far are XXXXX. “Wow! Another one?” Yes, indeed. You are pregnant. To insure a healthy baby – we recommend pre-natal vitamins. They are available from this office or at the drugstore.” “Wow! You are not interested in getting pregnant. Would you like information on contraception?” Does the person who has been tested HAVE to take PrEP? Is is a mandatory drug for anyone who was tested for HIV? Or is it just information that may educate the person having the test. I am confused. Does it have to do with controversy or a branded drug who is getting PR by this recommendation and thus creates a revenue stream? Does it constitute free advertising for one company? Is there a generic equivilant? Or is this just additional information so a patient can make an informed choice about their health.

    Of course Big Pharma lies. But viruses don’t know about Big Pharma. If you don’t want to suit up for sex – why isn’t knowing about this med simply good information. Having HIV has not proved to be a walk in the park for any person who gets it.

    I was recently tested for many things, including HIV – no one told me about PrEP. No one even mentioned the test results – I read them on a printout. The point here is this: how does “provide information about PrEP” translate into writing a prescription? Even those stupid ads on TV rattle off an entire laundry list of warnings. It’s a little like BCP. You have to follow the rules for them to work. This includes risks. And one risk is if you don’t take them as directed you can become pregnant. That is the case with most medications. I am still confused.

  7. I am proud of LGAB for unanimously supporting this item & I appreciate the council’s unanimous support. I don’t think the city is taking a stand on PrEP it’s just stimulating public awareness for an HIV prevention option.

  8. Lucas, you are correct. Its about providing information for another option for prevention, which a lot of people don’t know about. I’ve been on PrEP for almost 2 years, and still can’t believe how many people are unaware of it, or how it works.

    For those seeking INFORMATION (not a debate, or to post judgments about use of the medication), I strongly encourage people to join this Facebook group:

    https://www.facebook.com/groups/PrEPFacts/

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