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The welcome side effect of PrEP

Sunday, 19 October 2014 Written by // Guest Authors - Revolving Door Categories // As Prevention , Gay Men, Health, Sexual Health, International , Treatment, Living with HIV, Opinion Pieces, Population Specific , Revolving Door, Guest Authors

The Advocate says “A spike in relationships that bridge the so-called viral divide may be an unintended side effect of the use of PrEP for HIV prevention.”

The welcome side effect of PrEP

This is an excerpt of an article by Daniel Reynolds that first appeared in The Advocate here

It is not easy to surprise Alex Garner, the founding editor of Positive Frontiers, who conducts HIV awareness and prevention programs in cities across the country. But during a recent trip to Los Angeles, he noticed a change that made him pause: Since his last visit only a few months earlier, gay men were beginning to talk more openly about using the drug Truvada as pre-exposure prophylaxis, or PrEP—used by HIV-negative people to prevent HIV infection. 

Garner, who has been educating the LGBT community on PrEP since it was first approved by the FDA and is the creator of one of the first blogs on the subject, observed that the drug was being mentioned in online dating profiles and in hookup apps like Grindr. Moreover, gay men were more likely to admit in conversation that they were taking it, and they were discussing it in an increasingly “empowered, nonstigmatized way.” 

“I wouldn’t say it’s become ubiquitous, but it’s become more noticeable than it was six months ago,” he says, recounting that a friend he had not seen in years stopped him on the street to talk about PrEP, which for Garner was “a clear indication things are starting to shift.” 

This shift is good news for activists like Garner, who work to raise awareness and combat stigma regarding PrEP, which in studies has been shown to prevent HIV by 96 and up to 99 percent if administered daily. Until recently, advocating for PrEP has been an uphill battle. Notably, Michael Weinstein, the head of the AIDS Healthcare Foundation, has discouraged it due to his belief that it will decrease the use of condoms as well as his fear that gay men will not take it as prescribed, and he has branded it a “party drug.” The phrase “Truvada whore” has also come into use among gay men as a slut-shaming label akin to the scarlet letter pinned on Hester Prynne, although recently gay and HIV awareness activists and PrEP takers have reclaimed the phrase much like young people did with the word “queer” 20 years ago. 

Recent developments, including recommendations from the World Health Organization and the Centers for Disease Control and Prevention, have softened this stigma, particularly in light of the recent CDC report announcing that the annual number of new HIV diagnoses among gay and bisexual men between the ages of 13 and 24 increased by a staggering 132.5 percent between 2001 and 2011. WHO estimates that PrEP use by gay men over the next 10 years could reduce worldwide HIV transmission by 20 to 25 percent. 

The impact of statistics such as these as well as PrEP’s heightened visibility has affected areas beyond the medical world, including social dynamics among gay men. Garner believes that as a result of PrEP, serodiscordant (or “magnetic”) couples, in which one partner is positive and one partner is negative, are becoming much more common. 

“The fundamental dynamics between negative and positive men have shifted in a way that I personally haven’t seen in quite some time,” says Garner, who attributes this change to PrEP "and the understanding of what one’s undetectable viral load means.” 

Read the rest of the article here.