“Wild West” Ad Culture on Facebook Targets Youth




In a first of its kind, Facebook has been co-opted to advertise a pharmaceutical drug. Like Russian influence on the U.S. election, the use of social media targeted at vulnerable populations raises important questions.

By Kambiz Shekdar, Ph.D.

The drug, Truvada®, is an AIDS medication, but its online advertising isn’t targeted to AIDS patients. An entirely new drug market of teens and young adults with no history of HIV/AIDS is being created. The premise boils down to using the drug to replace condoms.

Gilead Sciences, Inc. manufactures Truvada. The company is not placing these ads, however it pays hundreds of millions to cash-starved LGBT and AIDS organizations that do. These organizations are followed by young gay men and trans youth, and inner city, homeless and runaway youth.

The ads on Facebook and the Facebook company Instagram bypass U.S. Food and Drug Administration, Federal Trade Commission, and Federal Communications Commission rules and regulations for ethical marketing of prescription drugs. The examples pictured here market Truvada interchangeably using its brand name, shape, color or medical use, referred to as pre-exposure prophylaxis, or “PrEP.”

New groups, websites and internet memes with more sexually explicit—and enticing—ads such as, @PrEP4Love, @PrEPPig and #TruvadaWhore also sprang up, some of which have since been taken down. The Instagram handle @PrEPoganda also documents the physical rollout of the advertising as it was plastered in New York City’s subways and gay neighborhoods.

What young gay man—for that matter what man, gay or not, young or old—wouldn’t prefer to have sex without condoms and without the fear of catching AIDS? Hearing this message from their own peers and not from some pharmaceutical company, what gay man wouldn’t want to jump in and join the responsible fun? And they did, posting it to their own accounts (see online).

Even if Truvada proves to be the miracle drug that single-handedly rids gay men and the world of the AIDS plague, direct-to-consumer advertising of prescription drugs on Facebook deserves a second look. First, we must prepare for any possible fallout if things don’t work out as advertised. Second, we must determine who may be held accountable should something go wrong.

One recent case study found that HIV in six percent of people living with HIV/AIDS (in this case in and around Seattle, Washington) has “high-level resistance” to Truvada (See “The Problem with Trump’s Pledge to End HIV” published by the Massachusetts Institute of Technology at Despite not knowing where else and to what extent Truvada’s usage would only provide partial protection, the new drug regimen was nonetheless blasted at full volume across the gay world.

Pumping healthy gay men full of powerful AIDS medications has indeed lowered HIV infection rates. In addition, next-generation drugs for PrEP may address any growing drug resistance. Unfortunately, the PrEP paradigm might also shackle generations of gay men to the increasingly powerful and obligatory drugs, just to have sex. Rolling out a powerful drug campaign prior to complete scientific and medical consideration may have been a Schnapsidee.

Misleading advertising by opioid manufacturers has been linked to the rise of the opioid epidemic, just as alluring advertising played a role in millions of tobacco-related cancer deaths. In the age of Facebook, misleading and alluring advertising is no less destructive. While Gilead may not have placed these Facebook ads, if there are #TruvadaWhores, who’s the pimp?

The author is a biologist, a biotech inventor, a gay man and the President of Research Foundation to Cure AIDS

SOCIAL MEDIA PROMOTION OF PREP by AIDS United; Chicago House & Social Service Agency; and Los Angeles LGBT Center.

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