I’ve always found talking about sexual health sexy. Tell me when you were last tested, when you last got treated for gonorrhea and how the injection in your arse cheek left you limping for the rest of the day, how handing a cup of warm pee through that hatch in the bathroom wall will always feels weird to you and how one time you had a really hot doctor who maintained eye contact as he was swabbing your dick. I love it. There’s little more attractive to me than a man who is in control of his sexual health and isn’t afraid to talk about it.
I grew up in the UK during the Section 28 era, when it was illegal for teachers to discuss homosexuality in school. I received no relevant sex education, and gay people were only acknowledged in direct relation to AIDS. As such, I am part of a generation of gay men who were taught to never feel desire without fear.
I started taking PrEP last year because I was tired of living under that shadow. I’m tired of trying to love with an axe hanging over my head, and I believe that at the age of thirty it’s high time for some sexual liberation. But liberation turned out to be very different from my early hopes.
More than half a year before I took my first blue pill I went to my doctor to get a prescription. Just a few weeks previous to that meeting, generic PrEP had been approved in Germany – where I now live – bringing the price down to a more realistic (but still expensive for me and impossible for many) €50 a month.
“Honestly, I wouldn’t recommend it for you,” my doctor said, after patiently listening to me talk through my reasoning. It was his gentle way of telling me that I simply wasn’t having enough sex to warrant taking PrEP, and that I was using condoms too consistently to be considered high risk. I accepted his advice and went home without my PrEP, but as time went by I found myself annoyed.
I am considered high risk for HIV infection – purely for the fact that I’m a man who has sex with men. I’ve never been allowed to give blood in either of the countries I’ve lived in; the ads on the U Bahn for the somewhat lucrative endeavour of being a sperm donor in Berlin have an invisible but very real ‘No Homos Allowed’ sign on them. Besides, it only takes one broken condom or one act of carelessness to get infected. So what does ‘high risk’ even mean? It felt arbitrary to me, which made me want to take control.
At my next STI screening I asked him about it again, and he wrote me a prescription for Emtricitabin/Tenofovirdisoproxil, no questions asked. I got off lightly on the side-effects, but for the first five or six days I felt lousy. Nauseous. Not sick, just like I was always about to throw up. But then it faded, and I’d done it. I was on PrEP! Protected and ready for liberation, here we go.
Just as quickly as my side-effects faded, so did my excitement. Within days, a partner of mine started making jokes-that-weren’t-really-jokes about my promiscuity now I was on PrEP. (After a week of feeling nauseous as hell, the number of men I’d slept with was a solid zero.) He then started urging me to talk to my doctor about ‘other strains of the virus from Asia and Africa’ and antibiotic-resistant gonorrhea, despite the fact that he wasn’t on PrEP and hadn’t discussed any of this with his doctor.
“I’m taking this drug to protect me, not you,” I said. I wasn’t about to be low-key slut shamed, especially not by someone I was having semi-regular casual sex with.
But across dating apps, the same thing kept happening:
“I don’t agree with PrEP because it promotes irresponsible behaviour.”
“How does PrEP make people responsible?”
“You’re just spreading other STIs even more…”
I do my best to tell it like it is. PrEP doesn’t inspire people to have loads of indiscriminate condomless sex; people will behave how they want to behave and deserve to be protected by the tools that are available; the threat of HIV isn’t a moral yoke for gay desire; people on PrEP get a full round of STI tests every three months at a minimum and are in general better equipped to have open and detailed conversations about sexual health. I don’t begrudge anyone’s choice to use condoms or not, and I definitely don’t see PrEP as a replacement for them, so it’s disappointing that my choice to protect myself in this way is often interpreted as a red flag. A sign that I’m (intentionally?) spreading other infections. That I’m ‘high risk’. This new sexual liberation business was exhausting, and not in the way I expected.
My takeaway from these conversations is that people – even GBTQ men – are still terrified of sex. Gay sex is still seen as something that can get out of hand, something that should be contained for the good of society. I’d find this hilarious if it wasn’t so dangerous. Judging people who take PrEP as anything less than responsible individuals looking out for their sexual health shuts down conversations and stops the spread of information about this important tool in the fight against HIV. Silence equals death, but in my experience speaking up has often left me feeling out in the cold.
The health ministry announced that PrEP will soon be covered by public health insurance in Germany, taking that €50 a month down to a round, beautiful €0. I hope the same follows for other countries soon, and that PrEP use will become even more widespread. As the barriers to access are further lowered and more people start taking it, I hope we can shake off this hand-wringing narrative about gay sex getting out of control.
Personally, I won’t let my desire be contained any longer. The laws that once regulated it were revoked in 1967 in the UK and 1994 in Germany. The shadow of fear that keeps desire in the dark recedes with every honest and hilarious conversation about sexual health, and with my coffee every morning as I wash down another little blue pill.
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