San Francisco Supervisor Scott Wiener made an unusually personal announcement for a politician this week, telling the world that "each morning, I take a pill called Truvada to protect me from becoming infected with HIV."
Wiener, who is gay, could be among the first public U.S. figures in recent history to make such a disclosure. He said he hopes the attention his case generates helps put an end to the negative stigma the drug carries for some critics who believe its use signals and promotes promiscuity.
The pre-exposure prophylaxis (PrEP), often referred to by its brand name Truvada, is the first drug approved by the FDA for preventing the spread of HIV.
Medical professionals and supporters of free access to preventative HIV/AIDS drugs expressed their desire at a San Francisco Board of Supervisors committee hearing today to see such drugs made available regardless of income.
Following a rally by supporters outside City Hall this morning, Supervisor David Campos held a hearing of the board's Neighborhood Services and Safety Committee to learn how San Francisco could become the first city to provide the preventative drugs to HIV-negative residents who otherwise can't afford them.
Wiener's online essay, "Coming Out of the PrEP Closet" appeared Wednesday evening in the Huffington Post. In it, he explains that taking these pills is a pre-exposure prophylaxis, or PrEP, that some researchers believe it may reduce the risk of infection by 99 percent if patients take their medication daily as prescribed.
"As an elected official, disclosing this personal health decision was a hard but necessary choice," he wrote. "After all these years, we still see enormous stigma, shame, and judgment around HIV, and around sexuality in general. That is precisely why I decided to be public about my choice: to contribute to a larger dialogue about our community's health."
Local
The announcement comes as Campos, who is also gay and running for state Assemblyman Tom Amiano's seat, announced on Thursday that he wants to provide making PrEP, more commonly known by its drug name of Truvada, "available to all regardless of income. Campos said such a move "could set the tone for the rest of the country in how to effectively eradicate a disease that claimed the lives of so many of our loved ones."
Campos held a rally on Thursday outside San Francisco City Hall, which Wiener attended, along with supporters who held Harvey Milk posters, paying homage to the city's late gay supervisor. Campos said this preventive care will save the city "millions of dollars, not to the mention all the lives that will be spared." His proposal, which he plans to formally introduce at next week's board of supervisors' meeting, would appropriate $807,000 to pay for "health navigators" to educate patients about the drug, and provide subsidies for those San Franciscans who can't pay for it.
A Campos spokeswoman said the one-time budget supplemental will augment someone's private insurance, HealthySF or Medi-Cal and any payment assistance offered by the drug manufacturer.
According to the Foster City-based Gilead, which makes Truvada, the drug can cost an average of $1,300 a month without insurance.
The rally comes hours after Weiner shared his medical course of action for a drug and a disease that still carry great stigmas. In fact, Michael Weinstein, president of the AIDS Healthcare Foundation told The Associated Press in April that the drug, while being hailed as a lifesaver, is "a party drug." There's even a "Truvada Whore" T-shirt and @TruvadaWhore Twitter handle.
Still, NBC Bay Area political consultant Larry Gerston said Thursday that the time is right. San Francisco, the hub of gay rights, is the place to drop that news, he said, especially "in an era of transparency," when "same-sex marriage is moving forward at lightning speed."
"Wiener is just getting ahead of the curve," Gerston said. "It's hardly a dangerous move."
The closest comparison Gerston could make to Wiener's announcement when when then First Lady Betty Ford admitted in the 1970s that she was an alcoholic and was getting help. That admission was a "monumental moment," Gerston said, sparking countless people to go into treatment themselves.
Wiener is telling other gay men that they should also seek help for their medical needs, and his story is now circulating widely, even grabbing a headline in the New York Times.
"I recently decided to be public about my use of PrEP in order to raise awareness about this relatively new tool for preventing HIV," wrote Wiener, who represents the Castro District in San Francisco where the majority of gay men live in the city. "It's important to encourage people at risk for HIV to talk to their medical providers about all the tools and methods available for preventing infection, including PrEP, and to choose the methods that are best for them."
The Food and Drug Administration approved Truvada (tenofovir plus emtricitabine) for PrEP in July 2012.
In May, the Centers for Disease Control and Prevention recommended that people at substantial risk should consider PrEP to prevent HIV infection. The World Health Organization and Centers for Disease Control and Prevention have recommended its use by those at risk for HIV, including gay men. The state of New York and the San Francisco Department of Public Health have adopted PrEP as a core prevention strategy.
Wiener said he wanted to use his position of power to effect some change, no matter the negative reputation of the drug.
MORE INFORMATION: The Truvada® for PrEP Medication Assistance Program assists eligible HIV-negative adults in the United States who do not have insurance obtain access to Truvada (emtricitabine and tenofovir disoproxil fumarate) for PrEP (pre-exposure prophylaxis). To find out if you are eligible for this medication assistance program, call 1-855-330-5479.
Bay City News contributed to this report.
Editor's note: An earlier version of this story misspelled Wiener's name in some instances. NBC Bay Area regrets the error.
