Real quick, for those of you unfamiliar with what PrEP is, here is a basic explanation. The initials stand for Pre-exposure Prophylaxis, and it refers to an HIV prevention strategy where HIV-negative individuals take anti-HIV medications before coming into contact with HIV to reduce their risk of becoming infected. The medication works to prevent HIV from establishing infection inside the body. It does not protect against other sexually transmitted infections or pregnancy and it is not a cure for HIV, but it has been shown to reduce risk of HIV infection through sex for gay and bisexual men, transgender women, and heterosexual men and women, as well as among people who inject drugs. Currently the only drug that has been approved for PrEP is a pretty blue pill called Truvada. Recent studies have shown that when the drug is taken consistently on a daily basis it provides 92%-99% reduction in HIV risk for HIV-negative individuals. And of course I have to be responsible in saying that it greatly reduces risk but does not eliminate it, and should be used in addition to other safe-sex protocols.
Now the point of this article is not about the cash cow element of the pharmaceutical industry making billions off of keeping people like myself alive rather than curing them, or how people mistrust the findings of scientific studies and find them inconclusive, or how expensive these drugs are – and Truvada is certainly not a cheap date…
I get it. And I actually do ascribe to some of those beliefs.
What I want to talk about here is the interesting phenomenon that has taken place with the advent of PrEP use among gay men: the judgement of one another.
You see, sex is fun. And one thing that many gay men including myself greatly enjoy is barebacking. But with many sexual acts, there is an exchange of bodily fluids and therefore a risk for sexually transmitted diseases. For a very long time, the act of barebacking was considered absolute no-go red flag behavior. It was a surefire means of contracting HIV which for many would lead to AIDS and eventually death. The viral medications that we have now were not available back then and the few treatments that were available like AZT would lead to more complications and toxic side effects. Barebacking would also lead to other STDs which compromise the body’s immune system and make it more susceptible to contracting HIV. Basically, fucking without a condom was treated like a social abomination.
The landscape is different now, and what is happening through PrEP use is that many gay men are ‘re-embracing’ their sexual expression by enjoying barebacking again. There are men on hookup sites like Recon that include in their profile that they are HIV-, but on PrEP. Some even take it to a celebratory hilt by referring to themselves as ‘Truvada Whores’. Leather boys that are under consideration for our collar have taken steps to get on PrEP as they want to enjoy being sexually intimate, which includes enjoying my fluids. Inside of them. Sorry for being graphic but let’s call a spade a spade – when you are sexually charged up with someone, the experience intensifies when you taste their cum in your mouth or feel them unload inside you. The use of Truvada is allowing a lot of men to feel free doing this again, and other gay men are feeling confronted by that freedom.
For decades our community was being tragically affected by so many people dying of AIDS coupled with a lack of available treatments and an unsympathetic government. People were losing their jobs, their families, and their grace by the travesty of this horrible disease and the lack of education. The oppression and the struggle became a part of our identity. When the anti-viral cocktails became available, the environment changed and suddenly people were not dying left and right. My own friend Drew actually got kicked out of hospice because he was suddenly going to live! There was finally the hope and breakthrough that we were fighting for. But I remember there were those that didn’t know what to do with themselves because they’re ‘fight’ wasn’t the same anymore. It was an integral part of who they were, and they would try to keep it alive. We are at another new phase of the landscape of HIV, and plain and simple, it’s a game-changer. Those that are embracing it are being harshly judged by others for doing so. We are essentially sabotaging ourselves within our community.
I talked of this dynamic with my doctor recently, and she was fascinated as she is a huge advocate for PrEP usage. She was saying that something very similar occurred in the sixties when the Pill became available as a means of birth control for women. She was saying that many Pill users were being harshly judged by other women for this new birth control means, with accusations of being irresponsible and promiscuous. Women were embracing a new opportunity to enjoy their sexuality, and other women were shaming them for it. Jealousy of one another was being expressed in the form of ‘false concern’. I see the exact same thing happening with gay men currently.
Regardless of how you may feel about PrEP, the fact remains that it is a new breakthrough approach to effective HIV prevention and is laying the groundwork for future medical advances. To go on PrEP is a personal choice and one that every individual should educate themselves about when they do so. But let me just remind everybody that a person’s decision to go on PrEP and enjoy their sexuality ISN’T ABOUT YOU. Yes you may express your concerns about other STI’s or a false sense of security and all that, but ultimately what this person elects to do with their body and their sexuality is their business and not yours. If that makes you angry, that’s something going on with you, not them. Perfectly well-meaning strangers will readily express their concern about the safety of somebody’s sexual actions, yet would never say to the person, “you’re obese and that’s unsafe. You should lose weight.” or “smoking’s bad for you. You should quit”. Also, if you have lost a friend or a loved one to AIDS – and almost all of us have – think about what they are saying right now as they are observing the shaming going on. Mine would say, “stop being stupid bitches to each other and take the damn blue pill.”
By the way I must share something ironic that happened recently. A friend of mine responded to my opinion on this with a tremendous about of vitriol, saying “you are promoting stupid, careless behavior that is justifying people to be unsafe and irresponsible.”
….he sent that to me as a text. While driving.