December 17, 2019 BY imani leave a comment
Since late summer, many LGBTQ+ Facebook users newsfeeds have been displaying medically incorrect targeted advertising. These ads pertain to Truvada, also known as PrEP, the one-pill-a-day pharmaceutical that has been demonstrated to reduce the likelihood of HIV transmissions by as much as 99%. “Side Effects from taking an HIV Drug …” reads one badly punctuated message, full of random capitalizations. “The manufacturers had a safer drug & kept it secret … They kept selling the dangerous one.”
That ad, which runs on Instagram as well as Facebook, is paid for by the Virginia law firm KBA Attorneys. It cites unspecified bone and kidney conditions as side-effects from Truvada, dangling the prospect of financial compensation from a future lawsuit against manufacturer Gilead Sciences.
Advocates took note and responded. “PrEP is safe and generally well-tolerated,” says Trevor Hoppe, a sociologist of sexuality, 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.
Addressing the ad’s claim of bone damage, 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.”
The most forceful response came in the form of an open letter that the LGBTQ+ advocacy organization Glaad published on Monday, December 9th, co-signed by more than 50 prominent LGBTQ+ and public-health organizations, with politicians like Governor Andrew Cuomo of New York and Senator Elizabeth Warren of Massachusetts subsequently joining. Calling on the social-media giant to remove the misleading ads, the signatories demanded that Facebook commit to “a review and potential update of current advertising policies to prevent false or misleading public health statements from reaching users”.
That reach may be quite extensive.
“There’s definitely more than one ad,” says Rich Ferraro, the chief communications officer for the LGBTQ+ advocacy organization Glaad. “There’s a range of personal-injury law firms running them, and there were millions of views on some of them.”
Using the Facebook Ad Library, the Washington Post determined that six anti-PrEP ads from personal injury firms Lawsuit Watch and Advocate Alliance Group got as many as 1.3m views on Facebook.
“Doctors were citing these ads as reasons why people who should be on PrEP were not,” Ferraro says. “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 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.
“Getting to Zero” has long been the mantra, a number that refers to zero new transmissions, zero deaths from complications arising from HIV/AIDS and zero stigma. In San Francisco, the number of new infections citywide went from a recent peak of 453 in 2012 to a low of 197 last year. Organizations such as the San Francisco AIDS Foundation have cited PrEP as a significant contributor to this success, always with the caveat that progress is fragile. Racial disparities remain, and hard-to-reach populations are often the first to fall out of care.
That Facebook tolerates debunked claims on its platforms shouldn’t really be a surprise. After all, the company has publicly disavowed any responsibility to factcheck political advertising, a profit-first decision reached despite widespread internal dissent.
Facebook did not return a request for comment. In the absence of a change in corporate policy, Glaad has decided to purchase an ad buy to promote its open letter, in the hopes that LGBTQ+ users read and share it.
“If they’re going to continue profiting off harming public health, our community is going to call them out,” Ferraro says. “As much as they support their LGBT employees, their platforms have become places where anti-LGBTQ organizations can do serious damage. Instead of trying to educate their audience, they are instead helping the spread of HIV by sitting idly by.”
It is the opacity and the lack of accountability that infuriates advocates as much as the false ads themselves – which continue to run.