Why Aren’t Gay Men On The Pill? Ctd

During a recent “Ask Anything” taping with Dave Cullen, to discuss his book Columbine for the 15th anniversary this month, he opened up about his experience with Truvada, which he’s been taking for almost a year now:

Meanwhile, the in-tray is starting to fill up with responses to my post:

Thank you so much for your writing on Truvada and celebrating it for the godsend that it is. I’m in a serodiscordant couple, so to hear it described as a “party drug” makes me feel ill. If eliminating fear at the heart of a relationship is a party, then, yeah, that’s a party I’ll go to. If wanting to fuck the person I love safely makes me a whore, well then I suppose I’m a whore. The names can’t hurt our community as much as HIV has. So if takes being called names to finally end this virus, then let them call us whatever they want.


Your blog has been one of the few places I can go for reassurance about PrEP ever since going on it six months ago. I am 28 years old and have grown up in a generation of gay men that has been taught that truvadanot using condoms is tantamount to instantaneous seroconversion. When I first started taking Truvada, I was excited to share my experiences with friends and loved ones. But since that time, I have decided to no longer disclose my use of prep, since I have experienced a significant amount of backlash from friends as well as prospective sex partners. It can sometimes be a passive remark, like a friend telling me that this is a “lifestyle choice.” Other times, it is a more brash statement, like “truvada whore”. They assume I am on the pill because of a sex life that is somehow more licentious than my counterparts that are not on prep, which isn’t true.

The advent of PrEP has created a unique relationship between those who are taking steps to prevent HIV seroconversion and those who already have HIV: a shared interest in treating and eradicating a devastating health threat. But in our own community, we continue to face backlash thanks in no small part to misinformation propagated by groups like AIDS Healthcare Foundation. On one side we see a group looking toward effective treatment options built on a foundation of openness. On the opposite side is a swath of gay men who stigmatize those who have HIV, and yet, are simultaneously wary of those men who take pills to prevent getting the HIV disease. A paradox, if ever there was one.

Another reader:

OMFG you spoke the truth here, thank you. What’s frustrating is that so few people are speaking it. Unfortunately, I am recently (December 2013) HIV positive. (Don’t date pathological liars.) However, the drug cocktail (Complera in my case) is amazing, and I’m already undetectable with no side effects, but it would of course be better if I weren’t on it in the first place.

I’d been active in HIV/AIDS related work heavily 15-20 years ago, when I was much younger, and fell out of it for various reasons, so it’s been an education diving back into the weeds of it. Because of highly effective treatment options, HIV is a fundamentally different disease than it was in 1999, when I was last in a job working with mostly HIV+ patients. It’s now a treatable, chronic condition and not a terminal illness, and one that’s harder for treated patients to transmit and one for which it’s possible for non-patients to get a pretty effective prevention drug for.

Yet it feels like the public health and prevention strategies are still stuck in 1992, when the disease was still a death sentence. No wonder HIV infection rates amongst gay men are rebounding. We need to fight the disease as it exists today. That disease profile includes the current prognosis, transmission risks and prevention tools, each of which has changed dramatically since current HIV public health measures came into place. It’s happening, but not fast enough, and that slow pace is causing more people (like me) to get infected unnecessarily.

Andrew, you can sometimes be a pain in the ass, riding your hobby horses, and sometimes I want to slap you. It’s your best AND your worst quality, and it can be infuriating, even when I agree with you. But it’s moved the needle before (gay marriage, anyone?), and I think you have an opportunity to move the needle here to save lives and reduce the infection rate. Agree or disagree with you, when you get passionate on a topic, you’re hard to ignore and you force the conversation into the open, and this is a conversation that’s not being had in the open enough.

So please make this the first of many posts on the subject, and infuriate and annoy the hell out of us. You’ll do a world of good.