Yes, I'm Still on PrEP, and Yes, I Still Think of It as a Godsend Seriously, Why Are More Gay Men Not Taking PrEP? And Why Has the Straight Community Practically Never Heard of It?

A

few weeks ago, I met a guy at Shade in Seattle. We chatted about books, Vonnegut in particular, and then we kissed for a while. When I found out he was only visiting Seattle for the weekend, I suggested he come home with me. He withdrew a bit and said, "Well, I should let you know. I'm poz."

I leaned in and said, "We're in luck. I'm on PrEP."

Bingo. We talked a bit more about other STIs, recent tests, etc. when we got to my house, and then we had a lovely time.

This is exactly why I take Truvada pills as PrEP (pre-exposure prophylaxis): I can make sure HIV—and the anxieties it inspires—won't stop me from bonding with someone new, however I choose to do that.

However, since my essay in The Stranger last fall, "The Case for PrEP, or How I Learned to Stop Worrying and Love HIV-Positive Guys," new concerns have arisen. My greatest concern is not whether Truvada works; I believe it does, especially when reinforced with condom use.

I'm most concerned about the widespread ignorance about the very existence of PrEP. While gay men, at least in urban areas, have caught on to PrEP's effectiveness, straight people commonly remain oblivious to the treatment. I've talked with science teachers, Peace Corps volunteers just back from treating HIV in Africa, and health-care workers here in Seattle, and they've had no clue about PrEP.

How is this possible? How can there finally be an HIV-prevention method that is 99 percent effective when taken daily, and most people haven't heard of it? It's more reliable and arguably easier to use than condoms. It's covered by many insurance providers, with coverage supplemented by newly emerging drug-assistance programs (including one here in Washington State, along with one from the drug's manufacturer, Gilead). PrEP is even endorsed by the World Health Organization and the US Centers for Disease Control and Prevention.

It's as though we're living in a post-HIV world, yet we haven't cured the virus. Much like the ludicrous idea that the recent victories for same-sex marriage signal the end of homophobia, there's a mostly unspoken sentiment that if people aren't dying en masse from AIDS, then HIV isn't a problem. Queer and straight people alike have lapsed into a lull in caring about the disease.

Part of this is generational. People in their mid 30s and younger have grown up in a world in which HIV has always been with us, like any other common but "preventable" hazard—like drunk-driving accidents. It wasn't a sneak-attack plague that turned our worlds inside out. Now that advancements in treatment have ensured that HIV is no longer a death sentence when treated carefully, it's easy for many to disregard HIV.

Even many members of the medical profession are unfamiliar with the use of Truvada as a daily pre-exposure treatment. When I called my insurance provider's consulting nurse service about flu-like symptoms, the nurse encouraged me not to rule out seroconversion (i.e., becoming HIV-positive), even though I assured her that I had taken Truvada religiously for six months, had not had sex in more than a month, and tested negative for HIV two weeks prior. A nurse has to be cautious, of course, but I got the impression that she really didn't understand the nature of PrEP. I eventually found out that my chart lists "exposure to HIV," leading one friend to joke that I have the word "slut" written in red across my file.

While this joke makes light of prejudice against both promiscuous people and HIV-positive people, it hits the exact nature of the lingering distrust of PrEP. Simply put, there's still a widespread prejudice among LGBT and straight folks alike that the people who contract HIV somehow bring it on themselves. After ignorance about the drug, the greatest barrier to more common usage of PrEP is a belief that taking it announces a surrender to sexual recklessness.

This is berserk.

Taking PrEP is precisely an act of responsibility for sexual health. The idea that using Truvada indicates some sort of "failure" to use other methods of HIV prevention is dangerous hogwash. Not everyone needs to rush out and get a prescription, but for those of us who have HIV-positive partners or frequent new partners, it's a godsend.

I have no idea how long I'll stay on Truvada. Right now, I need it. I'm single, I'm definitely not abstinent, and I refuse to reject anyone simply because of worries about HIV. I have more peace of mind and increased confidence because of PrEP. I wish you the same, however you come by it.