By Tamara Mathias

(Reuters Health) – Targeted advertisements on Facebook and television that overstate side effects of HIV-prevention pills might be the greatest threat to protecting people at high risk of infection with the virus, experts say.

The ads, sponsored by law firms, call for participation in class action lawsuits against Gilead Sciences, a California-based drugmaker that sells the only two U.S.-approved regimens of pre-exposure prophylaxis (PrEP) medicines.

Taking the once-a-day pills can stop the HIV virus from establishing an infection in a person who has been exposed.

In the journal Lancet HIV, Amy Nunn and colleagues say the ads target people who already take the pills and dissuade them from continuing to do so by making false claims about their safety.

Nunn, an associate professor of public health and medicine at Brown University in Providence, Rhode Island, says the advertisements “grossly overstate” rates of side effects like renal failure and bone loss.

“The fact that these are not just broad ads but that they’re targeting at-risk people who do not in general come across accurate information about HIV prevention is why they need to be removed,” Rich Ferraro, Chief Communications Officer at LGBTQ media advocacy organization GLAAD, said in a phone interview.

Peter Staley, co-founder of New York-based advocacy organization PrEP4All, which lobbies for expanded access to PrEP medication, says scientists have not been able to find any harm when TDF (tenofovir disoproxil fumarate), one of the medicines in Gilead’s PrEP regimen, is used to prevent HIV.

A Facebook spokesperson confirmed that its fact-checking partners determined some ads misled people about the effects of Truvada (Gilead’s combination of emtricitabine with TDF).

“We rejected the ads and they can no longer run on Facebook,” the company said.

However, several other ads continue to be displayed on the social media site.

“That was welcome news, but Facebook still has to take this over the finish line by creating a new policy that stops these ads from the get go, because waiting a month and a half for a fact-checking agency to get back to us on one ad is a bandaid solution,” Ferraro said.

The U.S. Centers for Disease Control and Prevention (CDC) recommends Truvada, often featured as a little blue pill in the ads, to prevent HIV for all people at risk through sex or injection drug use.

“Although these (adverse) responses to PrEP medication are exceedingly rare, CDC has advised clinicians to monitor kidney function regularly in patients who use PrEP, and not to prescribe PrEP to patients with abnormally low kidney function, or to patients with pre-existing bone conditions, such as osteoporosis,” a CDC spokeswoman said.

Nunn believes the ads are the biggest obstacle to PrEP uptake.

“Patients are coming in and quoting the ads because they’re so commonplace,” she said. “I have sent this to public health officials at the highest levels of government. They’re aware about this issue and many have responded that they are also very concerned.”

Gilead reiterated that its medicines are “safe and effective.”

“We have joined calls from GLAAD and leading organizations to have any misleading advertisements related to our HIV medications removed from Facebook,” a spokesman said.

“By decreasing public confidence in PrEP as a safe and effective HIV prevention method, these advertisements are having detrimental effects on the nation’s first-ever comprehensive federal effort to eradicate HIV,” Nunn and colleagues write.

SOURCE: The Lancet HIV, online February 4, 2020.