The drug that could end the HIV pandemic is already here. Branded Truvada, this pre-exposure prophylaxis (PrEP) prevents HIV infection by blocking the virus’s ability to replicate. “It’s a big deal,” says Robert Grant, a leading HIV/AIDS investigator at the University of California, San Francisco. “It’s an opportunity for uninfected people to proactively protect themselves.” Approximately 50,000 Americans will develop HIV this year. But since Truvada was approved as a PrEP in 2012, only 10,000 patients—or two percent of the 500,000 Americans identified as “high risk” by the Centers for Disease Control and Prevention (CDC)—have gotten a prescription for it.

Critics have vocalized concerns about side effects. “People have memories of what it was like to be treated with very high doses of drugs in the 1980s,” Grant says. “That lingers on even though HIV medication is much safer than it used to be.” In fact, Truvada has been used to help treat HIV for a decade. But, as with birth control in the 1960s, the concept of a pill regimen for safer sex was stigmatized, triggering a backlash against so-called “Truvada whores.”

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