Truvada — when taken by someone who is HIV-negative — is very, very effective at protecting you from HIV. Let me put it in a way that might have the most pragmatic value for the gay-man-on-the-street today: if you are HIV-positive and you are on HIV medication (and you have an undetectable viral load), you can have unprotected sex with your partner who is HIV-negative and taking Truvada, and the risk is exactly the same as wearing condoms (ie practicing safe sex).
Unfortunately not everyone is interested in spreading the good news. Truvada is proving as controversial for gay men as birth control was for women in the 1960s.
Nowadays, we look on the birth control pill as an unqualified success. The pill radically changed women’s lives, liberated them, and made them happier, healthier and able to control their futures. Without the threat of unplanned pregnancies, women pursued careers once reserved only to men, steering their lives in unimaginable ways. But back in the early ’60s, some were opposed to birth control. They argued that if women were freed from the fear of unwanted pregnancy, they would become more promiscuous. This was reason enough to want to hide the truth from tender, feminine ears.
Similarly, some people have tried to discourage gay men from using Truvada. Larry Kramer has said that “Truvada is for cowards.” The fear (much like the fears about women and birth control) is that gay men armed with Truvada will go crazy and have unprotected sex. And hence what should be important news shouted from every rooftop has barely made it into the headlines.