San Francisco Supervisor Scott Wiener talks Truvada, “slut shaming,” and his political fate

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Scott Wiener, a member of San Francisco’s Board of Supervisors, recently outted himself as a Truvada user. Taking the pill is a practice known as pre-exposure prophylaxis (PrEP), and some researchers believe it may reduce the risk of HIV infection by 99 percent if patients take their medication daily as prescribed. However, it carries stigma in the LGBTI community, with some critics arguing that PrEP encourages promiscuity and makes users vulnerable to other STDs. We sat down with Scott Wiener to discuss his declaration, in his office, in City Hall.

dot429: Describe in your own words what you do.

Scott Wiener: I am a member of the San Francisco Board of Supervisors. I represent District 8, which includes the neighborhoods of Castro, Noe Valley, Glenn Park, Diamond Heights, Twin Peaks and part of the Mission. 

dot429: As an elected government official, why would you advocate the use of PrEP? Are you a paid sponsor?

SW:  As an elected official, disclosing this personal health decision was a hard but necessary choice. After all these years we still see enormous stigma, shame, and judgment around HIV, and 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.

dot429: In preparation for this interview, I asked people on Facebook if they had any questions for you. This was a big concern: As taxpayers, why should we have to foot an $800,000 or more yearly bill to supply this drug when we won’t do the same for women and contraceptive and reproductive issues? 

SW: First of all, we should be providing free birth control for all women. I think it’s a fair question because it’s important to talk about other important sexual health measures, because PrEP shouldn’t be viewed as part of a vacuum, but as part of a broader effort to improve people’s health. The main issue here is the social stigma that’s attached. 

dot429: As in “shaming?”

SW: Yes, it’s “slut shaming,” to be exact. If you’re a gay man on PrEP or a woman on birth control, you’re perceived as a reckless, promiscuous, dangerous individual.

dot429: As a PrEP user and public official, are you afraid that people will see you in the same light?

SW: When Sandra Fluke (candidate for California state senate, District 26) announced that she was using birth control, she was immediately labeled a “slut” and “prostitute.” People oppose giving HPV vaccines to young girls because they think it’ll somehow make them sexually irresponsible. The same goes for gay men using PrEP. They’re vilified and seen as reckless men gambling with health. All these views are absurd and tragic. That kind of stigma is the antithesis of good public health. 

dot429: This treatment is incredibly polarizing. What would you tell to the pioneer generation of the 80’s, which first dealt with the AIDS epidemic, about PrEP and Truvada?

SW: If it had been discovered and available during that time, people would be lining up in the streets to get it. Furthermore, we’d be shaming people who weren’t on it, for not doing their part to stop the epidemic in its tracks. HIV is a manageable condition today, so much so that people go on to live long and productive lives.

dot429: The other fear is that people think this treatment also advocates not using condoms.

SW: No. Condoms are still a critical part in the prevention of HIV and other STDs.  

dot429: As a single gay man, do you still use condoms while using PrEP?

SW: Yes. It’s not an alternative to it. Condoms are still crucial to the prevention of STDs. The reality of our world is that five out of six gay men are not using condoms, and that’s pre-PrEP. We also know that condoms are not the total solution. They reduce risk by, I believe, 76 percent. It’s not perfect protection from HIV, just like it’s not for pregnancy. We should still continue to promote condoms, in addition to this preventative treatment.

dot429: What about the long term effects of using the treatment—specifically kidney failure?

SW: Truvada has been around for 10 years. It’s a small minority that’s experienced negative effects. As a norm, you should consult your doctor. My own doctor informed me that if your kidney function is good, those risks are quite low. And if you do decide to go on the treatment, it’s important to have regular checks to ensure that it’s taking well and, if not, go off of it. It’s not good enough to just give people access to PrEP, but we also have to give them access to overall medical monitoring.

dot429: When I was 16 years old, I dated an older man. I thought I was in love and wanted to have unprotected sex (before I knew better and dealt with my father issues). He said no, and bought me a copy of the play Angels in America.  What’s your advice for young gay men today who are just starting to be sexually active?

SW: I came to terms with being a gay man in 1987 and came out in 1990. My lesbian cousin’s partner, a bartender, started to take me out to the clubs in Philadelphia. She expressed her joy that I came out and wished she could introduce me to her gay male friends but couldn’t because most of them were dead or dying. That was emblazoned onto my memory. Many young gay men in our time have never known that. It’s very important for them to know what this disease has done and why it’s crucial to prevent new infections. They need to have access to all preventative tools, and that includes condoms paired with PrEP.

dot429: What’s next for you, as a political figure?

SW: I’m up for re-election In November, and I’m making the case for why the voters should go with me for another round. Also, there’s the soda tax, the fight against diabetes, housing, transportation measures, in addition to the issues I’ve worked on since I first got elected: public health and safety. 

dot429: Thank you for bringing up housing, public health and safety in San Francisco. What’s your plan for to improve the living conditions of the aging pioneers of the gay movement?

SW: First, the two are not mutually exclusive. We need to increase the housing stability of our current residents, including long-term HIV survivors. We also need to continue to work hard to end the transmission of HIV. Sometimes it’s suggested that if you’re working on one thing you are neglecting the other, but just the same they are both equally important. 

Housing: we need to reform the Ellis Act and take other measures to reduce the number of evictions and displacements in the city, but we need to also fix our structural housing and its dramatic shortage in the city. When you have a shortage of housing it puts enormous pressure on the stock and people who are low income. They often come out on the losing end. We need to remove that pressure by having more housing opportunities. I champion new legislation to create housing that doesn’t price them out. Along with measures for people who are on private disability who lost their homes, not because of eviction, but because they simply cannot afford it. Much still needs to be done.

About The Author

I was born in The Dominican Republic and was raised between New York City, New Jersey and Mexico. For the past 12 years I've worked as an events planner-producer for corporate, luxury goods and socials; in addition to opening three hotels in New York City and working as a chief concierge. I've been profiled in Vogue, The New York Observer, BizBash, Club Systems International and IN NY Magazine. I just moved to San Francisco to live & tell stories, while developing a TV show based on “The Art of Hospitality” and my website. Some of my essays and interviews have been published in The New York Times, New York Press, Huffington Post and Sheckys.com (I was their hospitlality expert).

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