High school students in Virginia’s largest school system will learn about daily medication used to prevent HIV as part of their sexual health education.
The Fairfax County School Board voted last week to include information about pre-exposure prophylaxis — PrEP — in the district’s family life education curriculum, which includes lessons on sexual health and sexuality.
It was one of several vigorously contested updates to the family life curriculum that culminated in a boisterous board meeting that devolved frequently into jeers.
The drug, known by the brand name Truvada, lowers the risk of HIV infection from sex by more than 90 percent, according to the Centers for Disease Control and Prevention. The daily pill is recommended for people at high risk of getting the virus, such as those in a relationship with someone who has HIV or gay men who have had sex without a condom.
The curriculum change appears in lessons that teach students about preventing and treating sexually transmitted infections. In addition to abstinence, which is already taught, students will learn that PrEP and condoms can help prevent transmission of the virus.
An advisory committee was directed by the school board to review the Fairfax family life education curriculum and to compare it with state standards. The advisory panel recommended that the school district include information about PrEP at all high school grade levels.
Robert Rigby, president of FCPS Pride, an employee group that advocates for the district’s LGBT students and workers, said informing students about the drug is vital.
“It’s a terrific tool in fighting the HIV/AIDS epidemic,” he said. “For our individual student who might be at risk at some point in their lives, it’s something they need to know about.”
The Food and Drug Administration approved Truvada in 2012 and, in May, approved its use as a prevention tool for adolescents at risk of HIV. A 2015 study conducted at Kaiser Permanente in San Francisco found that all of more than 600 high-risk people placed on a daily regimen of Truvada remained HIV-free.
Patients prescribed PrEP generally must return every three months to their health-care provider and be tested for sexually transmitted infections, said Megan Coleman, a family nurse practitioner at Whitman-Walker Health, a community center that specializes in medical care for people who are lesbian, gay, bisexual or transgender.
Coleman described the drug as a “really safe medication” and said it can have side effects such as fatigue, nausea, diarrhea or constipation. About 1,600 Whitman-Walker patients use PrEP, said Coleman, who is the center’s director of community research.
Fairfax isn’t the only school district in the region that includes PrEP in its curriculum. Montgomery County students began learning about the medicine in the 2017-2018 school year.
It’s difficult to track how widely PrEP is taught in schools, given the number of districts across the country, said Chitra Panjabi, president and chief executive of the Sexuality Information and Education Council of the United States, which advocates on sexuality and sexual and reproductive health and rights issues.
It’s crucial that students have sexual health information that can improve their well-being, she said.
“This is Fairfax County taking progressive steps to make sure young people are getting the education they need,” Panjabi said.
But Hope Wojciech, a Fairfax parent who opposes the addition of lessons about PrEP, said she fears that the school system won’t educate students on the medication’s potential dangers.
“It is unclear to me if the risks associated with this drug will also be presented to students,” she wrote in an email before the board meeting.
Wojciech said the “drug is highly toxic in doses used by adults and may cause permanent damage to kidneys and bones.” But according to the CDC, no serious or life-threatening effects have been observed in users who do not have HIV.
School board member Elizabeth Schultz requested that the board postpone the vote on the family life education changes, which were recommended by the advisory committee, to October. The board, she said, failed to adequately review public input.
Community members submitted more than 1,300 emails on the curriculum changes, containing thousands of comments opposing different aspects of the updates, school district documents state. The responses included more than 830 community comments opposing PrEP instruction in schools.
The approved curriculum, Schultz said, doesn’t reflect the community’s wishes.
“We get ourselves in trouble, as a board, when we navigate down paths that don’t include authentic engagement with the public,” she said.