Could an Anti-HIV Drug Discourage Condom Use?

Wednesday, July 23, 2014

Steven Valentino, associate producer for The Leonard Lopate Show, and Josh Barro, domestic correspondent for The New York Times, talk about the debate over the drug Truvada, which can prevent HIV infection when taken daily. It is recommended for at-risk men by the Center for Disease Control and World Health Organization and is part of Gov. Cuomo's initiative to slash HIV infection rates in New York State, but faces some resistance in the gay community over fears that it will result in other risks to health.


Josh Barro and Steven Valentino

Comments [21]

GS from Manhattan

What worries me is HIV + people that are "undetectable" How can the blood supply be trusted ? if you are HIV+ but it's "undetectable" ? I am expected to accept this ?? It is statements like this that make me suspicious of HIV science

Jul. 23 2014 11:41 PM
SG from Manhattan

@dissident I understand that you have a passion against anal sex. that is all well and good but it is useless. M/F anal sex does not cause these problems and why should gay men not be allowed to experience the intimacies that they desire as well. Yes you are correct that it is particularly dangerous for homosexual men HIV is a PH dependent virus requiring a relatively alkaline ph to survive such as is found in semen , blood and the anus ( 7.0) and which is not found in the Vagina which if healthy is around ph 3.5 to 4, is highly acidic and will destroy HIV on contact with this acidity. It may very well be possible that the introduction of the immunosuppression factors and immune reactivity of that anal sx introduces to gay men especially from many many partners thru a part of the body that does provide a vector in many ways into the blood stream may be the reason why this disease affects gay men and bisexual men that have sex with men almost exclusively. But to deny people their choice of intimacy dangerous as it can be is not practical nor "right".

Jul. 23 2014 11:35 PM
Shane from Chicago

I look at the drug as simply an extra layer of protection. I was on the drug before it was prescribed for PREP due to chronic hep b, and I can 100% say it worked for me. My partner was positive at the time, his viral load was undetectable, I was on the med and I'm fine. I'm not on the drug anymore, I went back to only tenofovir which is the only drug that is needed for hep b. I'm not sexually active and don't need prep. If I were sexually active I'd be on it it half a second. It works and the side effects for me were zero. The only issue I have is I think doctors (at least in my primary office) push it assuming you are at risk. It's an individual decision.

Jul. 23 2014 08:17 PM

@ GS from Manhattan:

You (incredibly) completely the ignore the anatomical and physiological realties of the ano-rectal cavity. In contrast to the vagina, the anus and rectum -- whether male or female:
- are lined with thin, delicate membrane that tears easily
- do not self-lubricate
- do not stretch easily and resiliently
- are filled with fecal pathogens
- reflexively resist entry

By /your/ logic, /any/ contact of semen between males should carry a comparable risk of infection to that of anal penetration. But this is simply not the case. It is the specific act of anal penetration that spreads HIV at a rate MANY times higher than any other form of sexual contact. With such non-penetrative acts as frot and intercrural, the risk is almost non-existent.

(All of this is elucidated in detail by Bill Weintraub at his site,
Weintraub, along with Rob McGee and many other dissident voices from within the homosexual communnity, also reveal the extensive indoctrination and conditioning that gay-identified males are subjected-to. Necessary, as revulsion and resistance to being anally penetrated is instinctive.)

Regarding, "a condemnation of the sexuality that people enjoy.", people enjoy all kinds of things that are dangerous and less-than-wholesome. You can argue that individuals should have the right to choose such indulgences for themselves but that argument only goes so far as when no one else is harmed. There is a clear public health imperative in regulating and even restricting any behavior that so disproportionately spreads communicable disease.

Jul. 23 2014 04:49 PM
GS from Manhattan

no value judgements ... let me interject the observation may not be about HYGIENE.. Which some people may associate with a condemnation of the sexuality that people enjoy. No we might consider that semen contains immunosuppressant factors, to facilitate navigation thru a female's immune system in order to fertilize. Compound that with what may be perhaps a female immune system that is more tolerant of foreign cells ( in order to accept and incorporate the dna from a stranger into her child ( which also has a different immune system ) and actually live with this immune system during gestation. Males from a biological function do not get fertilized nor bear many iterations of children which all have different immune systems each time ... as well as the possibility of different males fertilizing this same woman many times. long story short ... women are made with deal with multiple inseminations ... men are not ... IN fact any physician will tell you that males are allergic and will have an IMMUNE reaction to THEIR OWN sperm ... let alone other males because sperm is different than the normal body cells. It's not about HYGIENE... it's about immune reactions ... hence the name HIV......

Jul. 23 2014 02:43 PM
Truth & Beauty from Brooklyn

@ Dissident from Outside the Mental Herd:

"There is a simple means of preventing HIV that is FAR more effective than Truvada /and/ condoms, has no side effects and doesn't cost anything: Avoiding the act of anal penetration."

"Nowhere in my post did I claim that anal penetration is the /sole/ means through which HIV is spread."

Those are your quotes. You may not have meant to attribute the spread of HIV/AIDS solely to anal penetration, but your quote sure as h e l l sounds like you did.

"I realize, though, that the facts do not fit well with the agenda-driven, politically, socially and culturally correct, narrative (now state-sanctioned to boot) that you (and so many others) have obviously bought-into."

Before you start accusing people of having agendas, do a little research. My agenda is that of a Biology major with a Common Sense minor. This is solely epidemiological for me. How does one logically prevent the spread of a fatal disease that is sexually transmitted? Either by limiting the sex or by creating a physical or physiological or microbiological barrier. But there is a sociological aspect to this, as well, which is that of our increasing need for instantaneous gratification, leading to limitless sex with limitless partners. Basically, if you sneeze on your hand and then shake hands with everyone on the train, in your office and in your child's school without first washing your hands or using hand sanitizer, how many people will have colds by the end of the week? Well, the ones who washed their hands and/or used hand sanitizer after shaking your hand and before they touch their faces and food will be less likely to develop the cold. People who didn't shake hands with you at all may develop a cold if they were exposed by someone else, but not from you. And people who get the colds, but don't know that they have them, can, during the incubation period, pass them on if they happen to sneeze on their hands and shake hands with other people.

This is my agenda: teaching people who have colds not to sneeze on their hands; to wash their hands or use hand sanitizer after every time they blow their noses; teaching people not to touch their faces after they've shaken hands with people; and teaching people to wash their hands or use hand sanitizers on a regular basis, especially after shaking hands with unknown people.

The approach to HIV/AIDS is analogous. The results: fewer sick and dead. Period.

Jul. 23 2014 01:55 PM

"Truth & Beauty":

Nowhere in my post did I claim that anal penetration is the /sole/ means through which HIV is spread.

I was quite clear in what I wrote, as would be evident to anyone taking the time to read it.

I realize, though, that the facts do not fit well with the agenda-driven, politically, socially and culturally correct, narrative (now state-sanctioned to boot) that you (and so many others) have obviously bought-into. So it is not surprising that you would resort (once again) to the kind of obvious non-sequitur and strawman that you have in the past.

P.S. Among the surprises you would find if you were to look at the actual data relevant to the topic at hand, is that while oral-genital contact certainy transmits many nasty (and deadly) infections, there is considerable doubt as to what extent-- if at all-- HIV is among them.

Jul. 23 2014 12:04 PM
RZ from Washington, DC

Gay men make up the majority of those infected with HIV in the US, but hundreds of thousands of men world wide have gotten HIV through heterosexual sex. If heterosexual men have sex with a woman, who may have gotten HIV from IV drug use of having sex with a bisexual man, that heterosexual man can get HIV, particularly if there are any other STDs that cause open sores - including Herpes.

Jul. 23 2014 11:46 AM
SG from Manhattan

This is great news now we can concentrate on getting this drug's production costs efficient and low so that we can get it to everyone that needs it ...

Yes it is expensive considering that this is a lifestyle disease ( "oops I go to a BLACK party and do "bad things" there"....) but we should pay it. Every life is precious. " A lot of things happen there " perfectly acceptable for gay men ... " A lot of things happen there " would be the cue to start slut shaming straight men and women

Interesting thou .. we were always told that AIDS affects Heterosexual exclusive men and women also . Yet all the folks here are Gay and the emphasis is on Gay sex. While I am happy to see all the efforts to cure HIV infections come to successful conclusions....I have to mention the overreach and scare of exclusive heterosexuals and the MYTH that straight men can get AIDS from women. ( obviously this is insignificant. When ever these conversations are entered into it's ALWAYS about gay MEN.

Let's get as open about sexuality and truthful about EVERYTHING for EVERYONE

Jul. 23 2014 11:18 AM
Jacob from Manhattan

I hadn't heard about this drug until today so thank you. On the site for the drug it says it protects against HIV-1. My understanding is that, while HIV-1 is the most prominent strain, there are additional strains that are also out there. What protection would this drug provide for these strains?

Jul. 23 2014 11:17 AM
Jack from Manhattan


You're forgetting a huge question. Can closely held companies insist their health care insurers to ban the prescribing of Truvada based on religious grounds?

Jul. 23 2014 11:15 AM
Amy from Manhattan

Please be careful how you talk about monogamy. *Both* partners need to be & stay monogamous, & even if they are, 1 or both could have become infected from a previous relationship.

Jul. 23 2014 11:14 AM
op from usw

How well does Truvada work against HIV exposure when it's transmitted along with other venereal diseases like gonorrhea or syphilis?

Jul. 23 2014 11:12 AM

Mr. Valentino just provided a prime example of exactly what I was talking about. He claimed that until now, the only two choices for men who are sexually-active with other men for preventing HIV were condom-use or abstinence. Only through ignoring or de-legitimizing the real option of non-penetrative sex can one arrive at such a false dichotomy.

Regarding the "use a condom every time" cliché that was mentioned, here is an extremely apropos quote from blogger Rob McGee, mentioned in my initial post.

_______Begin Quoted Text_______
In 1985, which is to say just a few years before C. Everett Koop's AIDS letter, the Dutch government launched a two-pronged AIDS prevention campaign aimed at gay/bi men. The message was very simple:

(1) If you are a man who has sex with other men, the surest way to avoid AIDS is to abstain completely from anal intercourse.

(2) If you are unwilling to abstain from anal sex, you must use a condom every time.
"By the early '90s, the language of the Dutch campaign had been changed -- totally dropping the "don't have anal sex at all" suggestion. (Which was, let's remember, MERELY a suggestion, as the libertarian Netherlands had abolished its anti-sodomy laws as of 1813 .) In place of the two-pronged approach, the revised language put all the AIDS-prevention eggs into just one basket. That basket being, of course, "Use a condom every time you have anal sex." Which in no time at all got truncated to "Use a condom every time" -- thus subtly reinforcing the highly dubious notions that breaking-and-entry through the backdoor is not only "vanilla," but also the Default Mode of male/male sex."
_______End Quoted Text________
Full-text at:

Jul. 23 2014 11:11 AM
Truth & Beauty from Brooklyn

@ Dissident from Outside the Mental Herd: You are also outside the informed herd. The virus can be passed via vaginal and oral penetration, as well, so if you think you're safe by not engaging in anal sex, you're only fooling yourself.

I guess it's always better to take as many precautions as possible, but I think the most important precaution is not to engage in relations with strangers. Either you are in a monogamous relationship with someone who is HIV positive or has AIDS, in which case all due precautions are necessary, or you are having a physical relationship with someone you are 100% certain is HIV/AIDS-free. Either way, you know what you're getting into (npi).

It is interesting to me to hear that a transgender woman is talking about contraception as she can't conceive anyway. On the other hand, it means that she is less than discriminating about her partners. Too bad, and too sad. The only good thing is that she is taking precautions.

Jul. 23 2014 11:11 AM
Amy from Manhattan

Is Truvada available in countries (e.g., several countries in Africa) where AIDS is much more prevalent than in most Western countries? If not, what efforts are being made to get it to people there?

Jul. 23 2014 11:11 AM
Reuven from Washington Heights

Condoms protect against other STDS as well. Does Truvada?

Jul. 23 2014 11:07 AM

In terms of international epidemiology, Truvada is nothing short of a wonder drug and I hope the pharmaceutical companies are altruistic in their distribution of it to nations with increasing annual infection rates. But I also think that the loudest advocates of Truvada are incredibly irresponsible in their reasons for advocating Truvada. If I hear one more of them say “we have the right to have sex without fear” I’m going to pull my hair out. This is not about gay rights, it's about safety and trust and the inherent lack of both in our sexual climate - for homosexuals and heterosexuals alike.

Jul. 23 2014 11:06 AM
Sara from UES

What are the side effects of this drug?

Jul. 23 2014 11:00 AM
Dissident from Outside the Mental Herd

There is a simple means of preventing HIV that is FAR more effective than Truvada /and/ condoms, has no side effects and doesn't cost anything: Avoiding the act of anal penetration.

Said act is, after all, the single factor that accounts for HIV rates among homosexually-active males that are as high as FOURTY-FOUR TIMES those of the general population (CDC). And HIV is far from the only serious and potentially lethal infection that is disproportionately spread through this gruesome, inherently unhygienic act.

Yet, despite these clear, overwhelming facts and statistics, the mainstream gay and AIDS establishment have consistently fought even the mildest, merest /suggestion/ that anal penetration is best avoided and derided non-penetrative forms of male-male sex, refusing to even cover them as serious options in various campaigns and educational material.

Numerous examples of this are cited by such emphatically PRO-homoerotic voices as Bill Weintraub ( * ), who coined the term "Frot" for the phallus-on-phallus act that he advocates as the natural, safe, dignified and egalitarian form of male homosexual intercourse. Rob McGee also touts Frot on his blog at *
(*Graphic content)

Jul. 23 2014 10:38 AM
Mary from NYC

Just for accuracy - Truvada protects against HIV, not AIDS. A person becomes infected with the virus, not the disease.

Jul. 23 2014 10:03 AM

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