by Shaun Knittel - SGN Associate Editor In an age of instant communication, the lines can sometimes get crossed. Reporting on complex events - such as the medical trials of a new HIV/AIDS prevention pill - can get a bit tricky if not handled with care. Does the reader need an opinion piece, or just info? Should a blogger be telling someone whether or not they should take certain medications?

Remember the game Telephone, where you whisper a sentence into one person's ear, and by the time the sentence reaches the end of the group, it comes out completely altered from its original content? Well, that same thing can and does happen with information coming from researchers and drug companies when it is reported by opinionated media outlets.

With that in mind, Gay City officials decided this week that the best way for LGBT Seattleites to get information about oral pre-exposure prophylaxis (PrEP) - a pill touted as helping to keep men HIV-negative - was to hold a community forum and invite a panel of experts.

On April 27, Gay City, in association with HIV Vaccine Trials Unit Seattle and Seattle Gay News, presented the community forum 'The Magic Pill?' at ACT Theater in Seattle's Capitol Hill neighborhood.

The premise of the forum was for the community to come together to learn about PrEP, a medication some have dubbed the 'magic pill' for its apparent ability to help prevent HIV. Although its success rate is somewhat dismal (44% in the latest study), the pill sent the media abuzz with both praise and jeers.

Gay City officials brought in three distinguished presenters: Jared Baeten, M.D., Ph.D., an assistant professor in the departments of Global Health and Medicine and an adjunct assistant professor in the Department of Epidemiology at the University of Washington; Jim Pickett, director of Prevention Advocacy and Gay Men's Health at the AIDS Foundation of Chicago and leader of the International Rectal Microbicide Advocates; and Michael Weinstein, co-founder and president of AIDS Healthcare Foundation, to inform the audience about the three-year Pre-Exposure Prophylaxis Initiative (iPrEx) study which provided the first evidence that PrEP can help prevent HIV.

Forum attendees learned that PrEP involves the use of oral or gel-based antiretrovirals (ARV) by people who are HIV negative. A recent study involved men who have sex with men and Transgendered women who have sex with men. The iPrEx study focused on participants who were assigned to take an ARV pill daily. Because ARVs are effective for treatment of HIV, the hope has been that they can work to prevent HIV infection as well. The study involved 2,499 participants from six countries in the Americas, Africa, and Asia.

At the end of the study, there were 44% fewer HIV infections in participants who were assigned to take the medication every day compared to participants in the placebo group. In other words, the findings suggest that daily use of an ARV tablet can help reduce the risk of HIV infection among men who have sex with men and in the setting of a clinical trial that included a comprehensive risk reduction prevention package including frequent HIV testing, safe sex counseling, free condoms, and other measures for reducing HIV risk and ensuring safety.

Currently, four other large-scale effectiveness studies in different at-risk populations are ongoing. Results of these studies are expected in 2012 and 2013. One such study, FEM-PrEP, was called off. FEM-PrEP studied whether HIV-negative women who are at a higher risk of being exposed to HIV can safely use a daily dose of Truvada to prevent infection. Truvada did not show effectiveness in this study.

Many questions still remain about the use of ARVs for preventing HIV. The general consensus is that more information is needed before PrEP can be considered for widespread use, and more information is needed as to whether it is safe or effective in all people.

In short, the so-called 'magic pill' does not yet exist.

At the conclusion of the April 27 panel presentation, Baeten, Pickett, and Weinstein were joined by Austin Anderson, a project coordinator for the African American Testing and Brothers Link programs at the Center for MultiCultural Health in Seattle; Darren Augenstein, Pharm.D., MBA, AAHIVE, a pharmacist whose primary expertise is in the care of individuals living with HIV/AIDS and the co-owner of SeattleMeds Pharmacy, the only independent pharmacy in Seattle dedicated to LGBT health; Nick Literski, a local man using PrEP; and Fred Swanson, executive director for Gay City, to help facilitate answering questions from the audience.

The forum was an absolute success. Gay City got it right. The panelists were extremely knowledgeable, and while they were not always in agreement with each other, they provided informative input to allow the forum's attendees to form their own educated opinion of PrEP.

When was the last time any of us has seen over 100 members of our community together in one room having an open discussion about HIV/AIDS prevention? It's been years. Gay City officials and their volunteers were able to pull such a feat off in a seamless and welcoming manner. In addition, I applaud their choice of BDSM performance artist Tony Buff as host and drag artist Aleksa Manila as hostess. The two come from two very visible parts of our community and should be celebrated rather than pushed aside to make room for a boring suit-and-tie Gay host.

The picture that Aleksa and Tony - along with the sponsors, panelists, Gay City officials, and (most importantly) the audience - painted was that of a community that is ready and willing to come together to have a real discussion about issues that directly affect our community.

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