Op-ed: Put Away the Pitchforks And Let’s Talk About PrEP

In partnership between HIV Plus magazine and The Advocate, this series is a response to conversation about PrEP that's been derailed by slut-shaming.

We knew running a series about PrEP all through October would have its detractors. But some of you are so creative. Instead of hashtag #31DaysOfPrEP, one Twitter follower suggested we rename it #Slutoberfest.

That pretty much sums up why this series is necessary.

Discussion about PrEP has devolved into an argument over whether people who use Truvada — a pill that virtually guarantees you won't get HIV — are really just whores. You can actually go online and buy a T-shirt with the phrase "Truvada Whore" on it if you'd like to protest the slut-shaming so prevalent in what should be an intelligent conversation about our health.

You know something has gone terribly wrong when the latest numbers, shared in a recent story from HIVandHepatitis.com, show a mere 2,500 people have prescriptions for Truvada as PrEP. Surely the numbers should be higher for a drug that became available in 2013 and is now recommended as an HIV prevention option by the Centers for Disease Control and Prevention for all sexually-active gay and bisexual men.

For reasons that still make little sense to me, one side would prefer The Advocate and its readers not discuss the science behind all this. Instead, they just call you a whore if you take the pill. That ought to shut you up. That ought to keep you afraid of asking your doctor about it.

If you get so far as to obtain a prescription, I wouldn't blame you for hiding the pill bottle in the back of the cabinet. Most have kept quiet at brunch if friends dare talk about HIV.

No one wants HIV. But apparently what we're really concerned about is getting called a whore.

I don't know what motivates people to use this tactic, but I know where they learned it — from all these years fighting with the right wing.

Social conservatives have long tried to spin our desires as perversions. Rather than see us as human beings, we are portrayed as sexual animals.

Now the moralizing prudes are gay. They want you to worry that using PrEP makes you an irresponsible sex addict because it's so very simple to put on a condom. Just use a condom, instead of taking a daily pill, and it will ensure you don't get HIV. What's so difficult about that?

I understand, because that's true, condoms prevent the spread of HIV. But another bad habit these people have picked up while watching the right-wing is a willful disbelief of science and research — which conclusively shows condoms aren't being used.

Back in 2005, 48 percent of gay men said they'd had anal sex without a condom at least once in the previous 12 months. That's already a terrible success rate for advocates of condom usage. Then in 2011, that number jumped to 57 percent, according to a study by the CDC.

None of the increase is for lack of trying on the part of activists, who have put the wear-a-condom message out there for years in public service campaigns, and with free handouts at clubs and bars. No slogan can fix this.

Face reality: this is what gay sex looks like. Nearly 60 percent of us say we don't always use a condom when we should. Count me among those who weren't perfect while single.

It's time that critics of PrEP recognize they are part of the problem, that they are stigmatizing gay sex, as it actually exists. Quit living idealistically. Allow a real conversation based on facts.

Meanwhile, the number of new infections remains annually at about 50,000 — as it has year after year — and although gay men make up just 2 percent of the U.S. population (at least if you ask the CDC), we make up 63 percent of new infections every year.

The more widespread and insidious damage from shutting down conversation is on every gay man who is indirectly shamed for wondering whether PrEP is possibly a more reliable option than condoms. They're being shamed for not being infallible, and for wanting to be safer.

After all those years in my youth hiding being gay, and all this time as an editor covering LGBT issues, I have an almost automatic revulsion to shame. Anytime I get the familiar sense that someone is not just disagreeing with me, but judging me, and putting themselves on some higher moralistic plane, I get mad. It just feels like the closet all over again. In this case, it feels like detractors would like to put PrEP users in a closet, along with the realities of gay sex.

And that's why, no matter how many of them flood our social media timelines, The Advocate is stepping up with this monthlong series to answer questions about PrEP. The drug isn't right for everyone, and there's a good reason the CDC calls it an "option." Perhaps like birth control, this drug will evolve as more people take it. It's not some panacea either, since it can't protect against other STDs. Our goal is promoting real conversation so each of us makes informed decisions about our health. Your concerns about side effects, for example, should be answered by a doctor — not Facebook.

The genesis of this series came a few months ago while a friend was hosting an open thread on Facebook about PrEP, and the glut of misinformation being shared made me uncomfortable. I felt like The Advocate and all LGBT media were failing to do our job, and myths are being spread due to an information vacuum. Every single reader should at least have heard about PrEP. It’s that important. Yet so many myths were being talked about as facts that I knew we’d failed you. (By the way, check our special section for a series of myth-busting posts.)

I'd like to think information alone counteracts the PrEP-shaming. I'm in the information business because I hope truth matters. But, as you can tell, I'm also a realist. It's hard to turn away an angry mob by shouting facts and figures into the air.

We've learned quite a few things in this fight for our civil rights, including, most importantly, that visibility matters. Harvey Milk said the biggest difference toward obtaining our rights would be coming out. Are you taking PrEP? Say so. Explain why (like these men).

Years from now, you won’t regret having spoken up. But I suspect detractors of PrEP will one day find they have another thing in common with the right wing — that they were on the wrong side of history.

LUCAS GRINDLEY is editorial director for Here Media. Contact him on Twitter @lucasgrindley.