Michael Weinstein, president of the AIDS Healthcare Foundation, is many things—professional provocateur; contrarian pariah; enfant terrible of the AIDS activism world. But here’s one thing he is not: a reliable source on any matters relating to HIV/AIDS. Still, that hasn’t stopped myriad news outlets from reporting on Weinstein and the AHF’s pathetic, mendacious campaign against PrEP.
PrEP, marketed in America as Truvada, is an HIV-preventing once-daily pill heartily supported by the Centers for Disease Control and the World Health Organization. It’s a hugely effective, very safe, revolutionary drug that many gay men should consider taking. But the AHF has decided to wage a war against PrEP, claiming that the drug is a “public health disaster in the making.” Why? Because “people won’t adhere and take the pill,” leading more people to become infected.
Actually, the alarming uptick in unprotected anal sex, colloquially called “bare-backing,” among gay men is the “public health disaster in the making,” and PrEP is a smart, effective way to forestall calamity. When taken every day, PrEP is about 99 percent effective; when taken four times a week, it’s still 90 percent effective. The vast majority of its users seem to take it at least semi-regularly, making the drug potentially more effective than condoms alone at preventing HIV infection. PrEP’s efficacy has led scientists and AIDS researchers around the world to endorse it.
But Weinstein, who previously called Truvada a “party drug,” has decided to traduce PrEP as a useless disaster. The statistics he uses to do so are highly misleading. Weinstein claims that “under more or less ideal conditions,” Truvada only achieved a 50 percent risk reduction. But this is just not true. It’s settled science that taking Truvada once daily provides nearly complete protection against HIV. The real concern is whether people will remember to take the pill. Here, different studies have reported different rates: 92 percent of San Francisco users took it at least four times a week, while only 57 percent of Miami users did. But these figures merely suggest that gay men need to be educated about the importance of daily use—not that they should stop using Truvada altogether.
Why should we care what Weinstein says about PrEP? Actually, we shouldn’t. I asked Peter Staley, a hero of HIV/AIDS activism and a central figure in How to Survive a Plague, what he thought about Weinstein’s campaign.
“If there’s one thing that every aids activist knows,” Staley told me, “it’s that Michael Weinstein is not an AIDS activist. Yes, he’s the CEO of the ‘largest AIDS organization in the country’—based on revenue—but from the get-go, his tactic for building this empire has been taking contrarian positions that assure his placement in almost any article that appears about the latest HIV/AIDS debate.”
Weinstein attracted controversy early last decade by suing the pharmaceutical giant GlaxoSmithKline over its patent on AZT, an AIDS drug. Many AIDS activists believed the lawsuit was a frivolous distraction, but Weinstein succeeded in making headlines. He also threw a very public fit in 2012 when the Food and Drug Administration suggested it would approve Truvada, calling for Commissioner Margaret Hamburg to resign over her role in the drug review process. Weinstein’s letter was shrill and groundless, earning criticism within the gay community—but also drawing attention from the mainstream media.
Staley believes AHF partakes in this kind of opportunistic malfeasance for the sole purpose of “gold-mining the press.” Mainstream journalists are always looking for two sides of every story; Weinstein has taken it upon himself to take the contrarian position, even it that requires mangling and misreporting science. There’s an easy solution to this problem: Stop reporting Weinstein’s nonsense as though it’s real commentary. There are, to be sure, some nuanced concerns about Truvada—but its efficacy is no longer one of them. We shouldn’t give Weinstein the pleasure of creating a debate where one simply doesn’t exist.