The City of West Hollywood is being asked to take a stand on pre-exposure prophylaxis (PrEP), a controversial approach to HIV prevention.
The city’s Lesbian and Gay Advisory Board has recommended that West Hollywood require social services agencies with which it has contracts or collaborates to offer HIV testing to provide information about PrEP. The city’s Department of Human Services and Rent Stabilization will ask the Council to send the matter to the Human Services Commission so that it can draft a policy.
The Human Services Department recommendation notes that the city will have to figure out how to include such a mandatory requirement in existing social services contracts, and it notes that L.A. County already is considering a similar move. Many of the agencies with which West Hollywood contracts for HIV testing services work under contracts with Los Angeles County. The county Board of Supervisors last week passed a resolution ” to develop and implement a plan for a “robust, comprehensive program to deliver Pre-Exposure Prophylaxis (PrEP) throughout the County, considering a broad range of medical providers, including the Departments of Public Health and Health Services’ operated clinics as well as community based organizations and clinics, that can effectively provide PrEP to those at high risk for contracting HIV.”
The proposal before the Council doesn’t note that PrEP is the subject of a major debate among gay activists and health care providers. On the one side are organizations such as AIDS Project Los Angeles and the L.A. LGBT Center, which support making Truvada, the medication prescribed as part of the PrEP regimen, more widely available. The Centers for Disease Control also has endorsed PrEP for those at significant risk of contracting HiV because they don’t regularly use condoms, use illicit drugs or are in intimate relationships with HIV positive people. It stresses that PrEP must be combined with consistent use of condoms.
On the other side is AIDS Healthcare Foundation, the world’s largest non-governmental HIV/AIDS service organization, which has said that promoting PrEP will lead a reduction in condom use and thus a higher incidence of other sexually transmitted diseases and that there is evidence that some people on PrEP don’t carefully follow the regimen that requires them to take the Truvada pill daily. Others who have questioned PrEP include Regan Hofmann, an HIV-positive woman who is the former editor of Poz. Hoffman called Truvada, which costs $13,000 a year and is manufactured by Gilead, a “profit-driven sex toy for rich Westerners.” Dan Savage, the gay columnist, also has questioned whether gay men will use the drug consistently.
The Council will meet at 6:30 p.m. tonight at the City Council Chambers, 625 N. San Vicente Blvd. south of Santa Monica.