Has PrEP has gone mainstream? The CBC can’t seem to stop talking about it; Shonda Rhimes has written it into How to Get Away with Murder and most guys I talk to have at least heard about it by now, even if they’re still not sure how to get their hands on it, or how it works. As far as awareness is concerned we’ve reached peak PrEP. Now the scapegoating can really begin.
A number of concerning figures were recently released out of the U.K1. showing an increase in the number of STIs in men who have sex with men, and some in the gay media along with those against Truvada are already clamoring to place the blame on guys taking PrEP.
Is PrEP to blame? It’s worth noting that the link between PrEP and this increase in STI rates wasn’t formally established. Sad to say, but it’s largely a scare tactic used to generate headlines and shame people for the unspeakable crime of daring to enjoy having raw sex.
" Why have gay men been saddled with this responsibility of being the paragons of condom use? After all, if you’re reading these words it’s safe to say your parents liked it raw."
In truth, STI rates among men who have sex with men have been climbing for some time now, long before the advent of PrEP. It’s also important to note while awareness of PrEP might be at an all-time high, there are significant barriers to accessing it, especially for those that need it most. Not to mention the actual number of people taking PrEP is actually quite low.
Something that I’ve mentioned before, but may not be widely known is that in order to keep getting prescriptions for PrEP the CDC guidelines recommend screening for STIs. In other words, someone on PrEP is in constant contact with their doctor, and is regularly getting tested for bacterial STIs like gonorrhea and syphilis, whereas someone not on PrEP may choose to never get tested, or may only do so infrequently. The statistics on just how much barebacking is going on vary wildy but reality is that the number of people who can say they use a condom every single time is low.
I’ll admit, this whole thing hits a bit of a sore spot for me. Why have gay men been saddled with this responsibility of being the paragons of condom use? After all, if you’re reading these words it’s safe to say your parents liked it raw. I’m not ignorant to the devastating impact HIV has had on our community, but we now have a safe, effective method of prevention that can work in tandem with condoms. The real possibility of an HIV free generation is within our grasp, if we could only get over our petty squabbling and our fanatical devotion to respectability politics.
Perhaps it’s time to stop thinking about PrEP as just a pill, but rather a comprehensive protection strategy. It’s time to frame the discussion of PrEP as more than taking medication daily, but also a system for detecting STIs early, and supporting queer guys in harm reduction and safer sex management.
Taking PrEP is a safer sex strategy much as using a condom is, all we need to do is start looking at it that way.