Op-ed: Mom and Dad, I'm Taking Truvada

Dear Mom and Dad,

My Boy George costume was a hit! The hat I got when I was home for Christmas worked perfectly. I was the only Boy George, but there were amazing Madonna, and Prince, and Freddie Mercury costumes. My friend Bryn went as a Helmut Newton Palmer Girl in a jumpsuit, and her wife, Leila, was Adam Ant.

So, this is going to sound morbid, but I got a little spooked at the party -- I started thinking about AIDS. There were a lot of gay people there, and I got a gnawing feeling that it was disrespectful to have an '80s party, treating the decade like it was just a romp.

I bring that up because it's related to the main reason I'm writing. I want you to know that I've started taking a medication called Truvada. It's an HIV prevention drug. Studies have shown that if you take a pill every day, it cuts the risk of contracting HIV up to 99 percent.

When I came out, you both quickly mentioned AIDS. At that time -- 1999, speaking of Prince -- I thought AIDS was no longer the "gay plague" and that it was slightly offensive to immediately equate gayness with the disease. But recent Centers for Disease Control and Prevention statistics show that HIV really is largely a gay male issue: One in five gay men was infected as of 2010, compared with 0.3 percent of the total population. HIV rates have been on the rise among young gay guys, and a lot of them don't know their status.

So you were right to be worried! I want to acknowledge that, since I probably rolled my eyes at you during that conversation back in 1999.

I also brought up those CDC numbers because I'm assuming you haven't heard of Truvada, and I think the stats might help to explain why it hasn't been all over the news: Not only is HIV manageable now, but it might essentially be a niche concern for the likes of gay people and poor people, in this country.

Obviously, huge strides have been made since the early days of AIDS, when the media basically ignored the disease because it only was killing homosexuals and drug users. But I wonder if the media again is providing skimpy AIDS coverage because the development mainly affects gay people.

To be fair, Truvada's gotten quite a bit of press, some splashy -- New York magazine ran a cover story last summer. In September, The Guardian printed a long article with the headline, "Truvada has been called the 'miracle' HIV pill -- so why is uptake so slow?" It quoted experts who said public health agencies and healthcare providers are not educating people about this drug. The reporter did not bring up lackluster media coverage as a potential reason for slow uptake. How about "A Pill to End AIDS?" on the cover of Time? What would that do for increasing awareness?

Is such coverage justified? Consider how my mind raced when I first learned about Truvada. I thought this would be a watershed in the fight against an epidemic that ravaged this country and is still devastating many parts of the world. It would allow people with differing HIV statuses to have unprecedented peace of mind and intimacy. It would rile conservatives who see it as opening the floodgates for new levels of promiscuity and shake the foundations of a safe-sex culture that was thoroughly ingrained in my generation. There would be so many questions and rumors and doubts and legitimate concerns about such a pill's safety and its potential as a game changer in countries where AIDS still is rampaging. The disease killed more than a million people globally in 2013! If that angle is too international for U.S. news outlets, what about the hundreds of billions of health are dollars that could be saved in this country by stopping new infections?

Suffice it to say, I believe more urgent coverage is justified. Maybe in calling for attention specifically from Time, I'm revealing that I'm a fuddy-duddy 35-year-old. In the age of social media, if people truly care about something, shouldn't it enter the national dialogue without the spotlight of the so-called mainstream media? If this is true, maybe I have no reason to be dismayed by the relative lack of attention that Truvada has gotten.

But I am dismayed. At the '80s party, I asked Bryn if she had heard of Truvada. When she said no, I wanted to shout my explanation so that everyone at the party would hear. I thought about what Truvada would have meant to Madonna in the 1980s, when she lay in bed with friends as they died from AIDS-related complications. I thought about what it would have meant to Freddie.

I wanted to shout, but I quietly told Bryn about the pill, and I made a resolution to spread the word.

I've brought it up with Miki -- I thought that a 23-year-old woman living in Bushwick, working in fashion, with so many gay male friends, would have heard of it already. She had not.

I've brought it up with Joey, figuring that a 31-year-old with such a diverse media diet would know about it. At first no bells went off, then he said, "Is that the HIV med to prevent transfer?"

That bland, forgettable description is pretty typical of how Truvada is described in the media. I'm not one to clamor for sensationalism, but I think that more "miracle drug" articles would spur a wider, richer and needed conversation about this medication.

OK, I'll get off my soapbox! I'm happy to have a more in-depth conversation with you about my decision to take Truvada. But I simply wanted to tell you what Truvada is, and to let you know that being on it has brought me peace of mind. I hope it reassures you as well.

With love,
Tim

TIM MULLANEY is a health care journalist and fiction writer. For more information on Truvada as PrEP, read The Advocate's special 31-day series, which ran in October.