Truvada was hailed as revolutionary when it received FDA approval for HIV prophylaxis in 2012. When taken properly, the drug can reduce the risk of HIV infection among those who are at high risk by 92 percent, according to the Center for Disease Control and Prevention. But in the first two years since the daily pill’s introduction into the market, report after report from publications like the New York Times and the New Yorker have shown that gay communities have been slow to adopt the drug. Some doctors are hesitant to give the drug to healthy people; others think the protection of Truvada offers could lead to riskier sexual behavior. But Richard Elion, the director of clinical research at Whitman-Walker Health—D.C’s largest community-based provider of HIV services—calls this thinking “prejudicial” and compared it to the now-debunked theory that women would be more promiscuous if they had access to birth control. “It’s emotional and not logical,” he says.
Elion says that Whitman-Walker administers the drug to around 165 patients in D.C. About 100 of those are part of a National Institutes of Health study that looks at the impact of the drug in gay communities across the country. Although Elion was quoted in the Blade saying that use of the pill is “sluggish” in the D.C. area, he tells Washington City Paper that slow starts are typical for new medications and it can take up three years before a community adapts to a new treatment. “It’s a new paradigm,” he says. “Time will tell.”
Still, Elion says he would like to see more people in D.C. who would benefit from the drug take it. Young gay men not in monogamous relationships are considered at high risk for obtaining HIV. (The drug is also recommended for people who inject drugs and heterosexual men and women who do not use condoms and do not know the HIV status of their partners.) Elion says he hopes studies like the NIH one will help show that the drug does not change sexual behavior and that, by word of mouth and simply learning about the drug, more people will opt to take it. “Anything we can do to get people to help lower their risks, that’s good,” he says. “As a physician, if I’m not in support of saving lives, I’m in the wrong business.”