How to PrEP for the Future

Taking advantage of treatments like Truvada, which helps prevent HIV, is good preparation for the uncertain future of healthcare in our country.

My mother didn’t speak to me for almost a week after she found the empty bottle of Truvada I left at her house over the holidays.

She did some Googling and discovered it was a drug used to treat HIV as well as prevent it — a strategy known as “PrEP,” or pre-exposure prophylaxis — and took to her bed, shaken by PTSD.

Like most cool people of her generation, my mom lost a lot of people in the early ’80s, when HIV/AIDS decimated queer and artistic communities. I think the last person she knew with the virus had since died, so discovering that her daughter was taking medicine associated with something that killed so many of her friends was a shock. She assumed it meant I was sick.

Through her panic, I just kept reminding her that I am, and plan on remaining, HIV-negative.

Part of how I continue to stay that way is through this little blue pill, which blocks the HIV virus from infecting the body’s cells. In other words,

Truvada is helpful for people who are living with the virus, as well as those who aren’t and wish to stay that way.

People with access to viral-suppressing medications now enjoy long, full lives. But that could change, if the incoming administration makes good on its promise to gut both the Affordable Care Act and MediCal expansion.

California State Sen. Scott Wiener, the first public official to disclose his use of Truvada, says that what the Republicans propose could leave tens of millions of Americans without care — up to 6 million in California alone.

For people living with HIV, that could be nothing short of a death sentence.

“When you have HIV, it is so critically important to have stability in your meds, doctors, and care,” Wiener says. “It can be the difference between living and dying.”

He’s not exaggerating. In 2011, Vice President-elect Mike Pence defunded a rural Planned Parenthood clinic in Indiana, resulting in an HIV outbreak that left hundreds infected.

“When you start filling your administrations with science deniers, you run the risk of health agencies becoming politicized,” Wiener went on to say. “I could see what we saw during the Reagan administration happening again: health policy made on political grounds, and people dying.”

However, Wiener is unconvinced that the Republican-controlled U.S. Senate will make good on the TrumpPence threats. Senators running for re-election in 2018 may not want to slash the health care so many of their constituents have recently come to enjoy — even if some might not understand that the ACA and “Obamacare” are the same thing.

“All it takes is three Republican senators to say, ‘Let’s slow down,’ ” he says.

But if the worst does happen, we here in San Francisco are fortunate to have what Wiener describes as “an amazing network of community clinics,” which include organizations like the St. James Infirmary, SF AIDS Foundation, Lyon-Martin, The Ark of Refuge, and Strut, which provide services ranging from testing and counseling, to needle exchange, support groups, housing, and more.

Additionally, although the Healthy San Francisco program has shrunk in recent years as more residents have utilized plans through Covered California instead, if federal programs were cut, there is a local mechanism in place to get residents of this city access to health care.

“It’ll be a struggle,” Wiener says, “but that network exists — whereas in a lot of cities, it doesn’t.”

He emphasized that we have to support the local organizations with our time, resources, and money, so our community has a safety net for the future .

But it doesn’t stop there. We have to support candidates in other states and Senate districts that need protection, ensuring that anti-science rhetoric doesn’t become law in places much farther away than our own backyards.

“We have to be very vigilant,” Wiener says, toward the end of our phone call.

He’d caught me off guard, having called while I was waiting in line at the pharmacy to pick up my Truvada prescription (which currently costs me only $15 for 60 pills, thanks to my health insurance).

I have never lived in a world without HIV; the virus had already claimed thousands of lives by the time I was born. Now, I can take a pill no more expensive than birth control, which will prevent me from ever getting it, and which ensures that people who are living with the virus can live long, full lives.

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