Facebook Under Fire for 'Misleading' Ads About PReP

by Kilian Melloy

EDGE Staff Reporter

Tuesday December 31, 2019

Law firms looking for participants in a class action lawsuit against pharmaceuticals giant Gilead stand accused of flooding social media platforms Facebook and Instagram with "misleading" ads that mischaracterize the side effects of the PReP medication Truvada, media sources report.

Watchdogs worry that the ads will scare away the very people who need the medication most and counter work to stem the tide of the ongoing HIV/AIDS epidemic.

An open letter from more than 50 health organizations, LGBTQ advocacy groups, and HIV/AIDS groups asked Facebook to do something about the ads, reports NBC News.

The open letter states:

Using Facebook's and Instagram's targeted advertising programs, various law firms are attempting to recruit gay and bisexual men who use Truvada PrEP as an HIV preventative to join a lawsuit, claiming that the drug has caused harmful side effects in this patient population, specifically bone density and kidney issues.

Adds the letter:

This issue goes beyond misinformation, as it puts real people's lives in imminent danger. The U.S. Centers for Disease Control and Prevention reports that when taken daily, PrEP is highly effective for preventing HIV from sex or injection drug use. The CDC states: "Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily." The World Health Organization recommends that "people at substantial risk of HIV infection should be offered PrEP as an additional prevention choice, as part of comprehensive prevention."

.... By allowing these advertisements to persist on their platforms, Facebook and Instagram are convincing at-risk individuals to avoid PrEP, invariably leading to avoidable HIV infections. You are harming public health.

Reports NBC:

The ads were bought by various law firms looking to use the platform's targeted advertising capabilities to recruit gay and bisexual men for a class-action lawsuit against Gilead Sciences, the pharma giant that manufactures Truvada, a once-a-day pill that when taken regularly is 99 percent effective at preventing HIV transmission, according to the Centers for Disease Control and Prevention.

The ads also accuse Gilead of failing to release a "safer" PReP medication.

NBC notes:

The open letter, signed by groups including ACT UP New York, amfAR and University of Chicago Medicine, claim the ads are misleading because they give the impression that PrEP may be generally harmful, when the side effects the ads warn against are primarily an issue with long-term treatment for people already living with HIV.

PrEP stands for "Pre-Exposure Prophylaxis," meaning that Truvada is intended to help HIV-negative people avoid infection. Truvada has been clinically proven to be 99% effective in protecting HIV-negative people.

The drug came in for criticism shortly after its introduction by groups wary of the possibility that a viral breakthrough could occur and catch the gay community unaware. Still, public health experts say that PrEP is an effective means of combating the AIDS epidemic.

The ads seemingly target gay men on social media, reports say. NBC quoted PrEP activist Peter Staley as saying, "For the last six months, they've been targeting gay men on Facebook and Instagram with visuals about PrEP, the word PrEP and the blue pill, which is very iconic now for PrEP users."

Added Staley: "They're scaring the shit out of anybody who's seeing them."

The open letter expresses similar concerns, reported Medical Express:

"The advertisements are targeting LGBTQ Facebook and Instagram users, and are causing significant harm to public health," the letter states. "The law firms' advertisements are scaring away at-risk HIV-negative people from the leading drug that blocks HIV infections."

UK newspaper the Guardian, reporting on the ads, took note of the medication's safety and also reported on the so-called "Bone Disease" the ads made reference to:

...the San Francisco Aids Foundation says Truvada's effects are "not clinically significant", adding that it "has been shown to cause a 1% decrease in bone mineral density, a change that reverses once the medication is stopped."

Furthermore, the Guardian noted:

"PrEP is safe and generally well-tolerated," says Trevor Hoppe, a sociologist of sexualty, medicine and the law. "Any misinformation to the contrary is likely bad for public health, especially communities hardest hit like gay men in the US."

The Washington Post looked into the story and found that six different ads about PrEP were circulating on Facebook, al of them from the same personal injury firms. The Pst estimated that up to 1.3 million people had seen the ads on Facebook.

The use of targeting strategies to home in on gay men with the anti-PReP message was worrisome, said GLAAD's Rich Ferraro:

"Doctors were citing these ads as reasons why people who should be on PrEP were not...

"What makes them so unique is the targeting ability. There's a drought of information about HIV-prevention in mainstream media and even in LGBT media, and so at-risk people are seeing them in their newsfeed."

The Guardian summarized the fears around the ads' possible effects on the gay population:

The risk here isn't so much that people may be misinformed as that it could roll back decades of hard-won progress against HIV/AIDS. In working to transform the disease from a death sentence to a chronic condition that can be managed with appropriate treatment, public health advocates have worked tirelessly to establish trust and bring hard-to-reach populations like sex workers and intravenous drug users into the system.

Facebook has responded to calls to remove the ads with the assertion that the ads do not violate the social media platform's policies and contends that third party fact checkers have not flagged the ads as misleading or false.

Ferraro told the newspaper that Facebook would act to remove spurious and misleading content "when experts question things," and said that GLAAD had reached out to five agencies that offer fact checking.

But Ferraro also cautioned about a sixth supposed fact-checking group, the Guardian reported:

...a partnership with a subsidiary of the website the Daily Caller, an "alt-lite" site founded by Tucker Carlson and known for deliberately outrageous headlines, spuriously trolling LGBTQ+ people and referring to trans rights as "special treatment".

Said Ferraro: "The fact that the Daily Caller is potentially making a call on ads that deal with issues of HIV prevention is something Facebook should not hide behind."

NBC quoted Dr. Demetre Daskalakis of the New York City Department of Health and Mental Hygiene, who told the news outlet of his own experience with patients who were frightened by the ads and asked to be taken off Truvada. Said Dr. Daskalakis:

"We're all seeing and hearing the same thing, which is that this has a pretty significant chilling effect on trying to get folks on to pre-exposure prophylaxis, especially in communities that already have a baseline issue with medical trust."

Democratic lawmakers were quick to respond to reports of how the ads might endanger public health, including New York Gov. Andrew Cuomo and Massachusetts Sen. Elizabeth Warren, NBC News reported.

Wrote Warren:

"Facebook needs to put the safety of its users above its own advertising profits."

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.

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