Scott Wiener has become one of the first politicians in the US to announce publicly that he’s taking PrEP (pre-exposure prophylaxis) in order to reduce the risk of HIV infection.

Mr Wiener, a member of the San Francisco Board of Supervisors, went public on Wednesday in an op-ed published by the Huffington Post.



“Each morning, I take a pill called Truvada to protect me from becoming infected with HIV,” he wrote. “This strategy, also known as pre-exposure prophylaxis, or PrEP, reduces the risk of HIV infection by up to 99% if the pill is taken once a day.

“This makes PrEP one of the most effective HIV prevention measures in existence. After consulting with my physician, I went on PrEP to further protect and take personal responsibility for my health. I’m HIV negative, and I want to remain that way.”

Mr Wiener took the decision in order to raise awareness for gay and bisexual men living in his city.

He said: “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.”

“As an elected official, disclosing this personal health decision was a hard but necessary choice,” he said. “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.”

The San Francisco politician spoke movingly about his personal background.

“My journey to PrEP was a long one,” he said. “I came to terms with myself as a gay man when I was 17-years-old in 1987, at the height of the HIV epidemic. Many gay men were getting sick and dying.

“Like many in my generation, I came of age associating sex with illness and death. That association – with all the fear, anxiety, guilt, and shame that go along with it – is still very real for many of us.”

Mr Wiener represents an area that includes San Francisco’s famous Castro district, one of the first LGBT neighbourhoods in the US.

He wrote: “Nearly one in four gay men in San Francisco is HIV positive – and an even larger number of people at risk of becoming positive. As an elected official in this role, I have an obligation to do everything in my power to support those living with HIV, increase public awareness about effective HIV prevention, and reduce stigma and shame.”

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As of the end of June, 15,971 San Franciscans were living with HIV, with 85% of new diagnoses occurring among gay, bisexual and transgender populations, according to the San Francisco Department of Public Health.

PrEP, which can cost as much as $14,000 (£8,590) a year, is available to those insured by Medi-Cal, California’s Medicaid programme for the poor, as well as with many private providers across the US.

Mr Wiener said the challenge was to extend access. “PrEP isn’t cheap, and for the many people who are uninsured or underinsured, cost can effectively deny access.

“PrEP needs to be easily available to all communities and all income levels through public healthcare programmes, including Medicaid. Otherwise we risk accentuating health disparities among our diverse communities.”

In the UK, PrEP is currently still in its experimental trial period, but some campaigners are already calling for it to be made available on the NHS.

In July, the World Health Organisation stated gay men should consider using PrEP as an additional method of preventing HIV infection alongside the use of condoms.

The announcement generated a mixed response. British journalist Patrick McAleenan feared such a sweeping statement could stigmatise gay men and undermine condom use.

However, other health campaigners welcomed the WHO’s intervention, viewing it as a watershed moment in the debate on HIV prevention.

Public Health England – the health agency which is currently co-sponsoring a two-year study into whether PrEP should be made routinely available on the NHS – welcomed the WHO’s intervention.




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