When Adam Zeboski started using the HIV drug Truvada in November 2012, he was HIV-free himself, but in a relationship with a man who had been infected.
He was taking one Truvada pill a day for prevention, or PrEP – the breezy term for pre-exposure prophylaxis. Multiple international studies had shown that daily use of Truvada could nearly eliminate the risk of contracting HIV.
But PrEP wasn’t something most of Zeboski’s friends talked about, and even fewer admitted taking. Even in progressive San Francisco, “there was a lot of disapproval,” Zeboski said.
“People were talking about how PrEP would turn you into a slut,” said Zeboski, 26, who is an HIV testing counselor with the San Francisco AIDS Foundation.
The negativity came from gay men and their friends and families, from doctors and other health care providers, and even from advocacy groups that wouldn’t fully endorse Truvada for prevention.
And that’s part of the reason why, two years after the drug was approved by the U.S. Food and Drug Administration for prevention, and more than four years after studies showed it to be effective, very few people are actually using PrEP.
But that may be about to change. Last month, the U.S. Centers for Disease Control and Prevention released the first recommendations for who should consider the drug, focusing on groups of people at highest risk of contracting HIV. The recommendations would apply to roughly half a million people in the United States – a radical jump from the 2,000 or so currently taking PrEP.