December 12, 2019

On Dec. 9, GLAAD (prior to 2013, known as a the Gay and Lesbian Alliance Against Defamation), released an open letter to Facebook calling on its Chair and CEO, Mark Zuckerberg, to remove all Facebook and Instagram messages that “are convincing individuals to avoid PrEP” by claiming that it is “invariably leading to avoidable HIV infections.” These misleading ads, the open letter states, are “causing significant harm to public health” by “claiming that the drug has caused harmful side effects” among people who use it.

The open letter was spearheaded by GLAAD and co-signed by over 50 organizations, including the Academy.

Last summer, we noticed these ads being posted by personal injury lawyers in increasing numbers. We responded to this issue by developing an easy-to-read fact sheet explaining that these ads are incorrect and are urging Academy members to make copies and distribute to their patients and in other venues where they will reach potential PrEP users. The fact sheet is designed to warn Facebook and Instagram users and their communities that these ads are inaccurate and misleading – and provide them with correct information about the value of PrEP. More copies of this sheet are available for free download here or by request.

With HIVMA, the Academy also co-authored a commentary in POZ magazine on the subject.

The messages in the false Facebook ads about PrEP are also extensively contradicted by other sources, including the U.S. Preventive Services Task Force (USPSTF). The USPSTF, a Congressionally-appointed body, approved the use of Truvada for PrEP earlier this year, designating it both safe and effective. This designation enables the ACA to require that it be paid for by most private insurers and Medicaid expansion programs. Unfortunately, this requirement cannot be enacted until one full “plan year” after the USPSTF ruling (which will be 2020 or 2021 for most people – depending on their coverage).

A third recent development contradicting Facebook’s decision to allow the ads is the Administration’s move to provide low income Americans with free PrEP. On Dec. 3, Health and Human Services Secretary Alex Azar announced that his department would, “with donated drugs and services provided by major pharmacy chains,” deliver free Truvada to 200,000 HIV-negative uninsured Americans who needed it. According to Scientific American, Gilead will donate the medication and the government will “cover costs of the program, which include determining if someone who applies is eligible as well as distribution and processing claims.”

Whether the anti-PrEP ads appearing on Facebook will discourage individuals targeted to benefit from this Administration’s PrEP offer remains to be seen. According to Pew Research Center, however, “lower income teens are more likely than high-income teens to use Facebook.” In 2018, 70% of those living in households with $30,000 or less annually used Facebook versus 36% of those from households with $75,000 or more annually. It is foreseeable that the Facebook ads, if continued, may cripple this attempt to expand PrEP. Many people considering the new DHHS program are also likely Facebook and Instagram users.

According to Washington Post, these ads “have been viewed millions of times in recent months.” How do we prove that large numbers of young people at high risk of HIV will not lose their chance for protection because Facebook chooses not to reject false advertising? How do you prove a negative?