The World Health Organization has for the first time thrown its support behind the use of pre-exposure prophylaxis (PrEP) to prevent HIV among men who have sex with men (MSM). In a rash of hyperbolic reporting on the announcement, numerous media outlets have misreported that WHO says all gay men should take PrEP. News sources ranging from the Atlantic and Time to the blog Joe. My. God. have published some version of the inaccurate headline. Comment threads in response to the inaccurate reporting have reflected an ugly uproar from those who are indignant over the notion that WHO would categorize the controversial HIV prevention method as an imperative.
In fact, as Gay Men’s Health Crisis public policy director Jason Cianciotto reported in the Huffington Post, WHO’s actual language about PrEP was much more measured: “Among men who have sex with men, PrEP is recommended as an additional HIV prevention choice within a comprehensive HIV prevention package (strong recommendation, high quality of evidence).”
WHO’s new recommendation came as a part of a series of guidelines that seek to address what the agency argues is the globe’s inadequate response the needs of many of those most at risk of HIV, including MSM, prisoners, injection drug users (IDUs) and transgender people. WHO released this “Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations” in anticipation of the International AIDS Conference in Melbourne, Australia, beginning July 20.
The guidelines state that the various high-risk groups ’ have a lack of access to HIV prevention, testing and treatment services. Only 70 percent of surveyed nations explicitly address MSM, 70 percent discuss sex workers, 40 percent mention IDUs, and almost none speak of transgender people in their HIV prevention plans.
Discriminatory laws, WHO notes, can also be a roadblock to effective HIV prevention, such as laws that criminalize sexual behaviors, drug use, gender expression or individuals’ perceived sexual orientation.
“None of these people live in isolation,” Gottfried Hirnschall, MD, MPH, director of the HIV Department at WHO, said in a release. “Sex workers and their clients have husbands, wives and partners. Some inject drugs. Many have children. Failure to provide services to the people who are at greatest risk of HIV jeopardizes further progress against the global epidemic and threatens the health and well well-being of individuals, their families and the broader community.”
WHO states that mathematical modeling suggests PrEP could cut new annual HIV infections by 20 to 25 percent among MSM, for a cumulative reduction of up to 1 million new infections around the world over a decade.
To date only the United States has approved a drug, Truvada (tenofovir/emtricitabine), for use as PrEP, with South Africa perhaps the next country in line to do so.
To read the Time story, click here.
To read the WHO release, click here.
To read the Huffington Post story, click here.
To read the Joe. My. God. post, click here.
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