Continuing our discussion on gay men’s relationship to shame and sexuality, Greg Mitchell talks about his experience of being on PrEP, the controversial new HIV prevention treatement…

I’m Greg Mitchell and I’m a Truvadawhore. I take one pill a day (Truvada) and that stops me getting HIV. It’s called PrEP (Pre-Exposure Prophylaxis). However, some in the gay community think taking PrEP makes me a bad person: irresponsible, a slut, a whore.

I’m a product of the pre-AIDS generation. I remember a time when there was no HIV. Somehow I survived the worst of the AIDS epidemic and I’m still HIV negative. How I got here is no doubt down to a little judgement and a lot of luck. Statistically I should be a statistic.

Back in the 80s the fear of AIDS stopped me having sex completely for quite a while. But eventually I started again. I used condoms and I hated them. Sex could still be good, but it wasn’t the same.

However, with the advances in HIV treatment, I’ll admit my adherence to safer sex started to falter. At first it was just what they call ‘dipping’: when you put it in for a few minutes, and think: ‘that doesn’t count’. Then there were other occasions when I wouldn’t use a condom at all. There would be discussion, ‘risk assessment’, and I would decide to take the risk.

I was finding it harder and harder to use condoms. I’d lose my erection. I’d become so fixated on the business of getting the packet open, and the bloody thing on. I was beginning to give up the idea of penetrative sex altogether. So PrEP seemed like a miracle, and it’s changed my sex life.

Because it has removed anxiety. I know I can’t get HIV. I know I can’t pass it on. That is a liberating feeling. Short of a vaccine, I thought it the most important advance in HIV research since the discovery of anti-retroviral treatments. My family and my straight friends agreed, so I was astonished to find that many in the gay community were less enthusiastic. Why?

Ultimately I think some of the negative reactions come down to shame. Gay sex, any gay sex, has long been about shame. It wasn’t that long ago that it became decriminalised here (in fact it was still illegal when I was growing up), and in 81 countries around the world it is still against the law. In the 1980s it became even more shameful as we discovered it was one of the transmission routes for a deadly disease.

“Because PrEP can eliminate the difference between negative and positive. We can become a community that is no longer split by our HIV status.”

Before that time condoms were for preventing babies. No gay man would ever consider using one, but, as our brothers started to die around us, we realised it was either put a rubber on it or become another statistic.

And that’s when condom-free sex became shameful. We even coined a new word for it, a loaded word that carried with it a sense of risk. Barebacking. New treatments meant that HIV was no longer deemed a death sentence. Still, I’ll wager most of the people indulging in occasional condom-free sex end up feeling guilty for ages afterwards, hoping against hope that when they next test they will be okay. But that probably starts a pattern. Once you get away with unsafe sex once, you try again and again, until one day you go for that test and it comes back positive.

I am also convinced that many of those who condemn the use of PrEP are under the misapprehension that those gay men testing positive are just the dirty gay guys, the ones who go to weekend sex parties and take lots of drugs, and no doubt there is an undercurrent of feeling that they deserve it. Good gay guys subscribe to the hetero-norm, they meet the man of their dreams and settle down in a monogamous relationship, whilst the bad ones have multiple partners and go to cruise bars and sex clubs.

But many of these ‘good gays’, the ones with boyfriends, the ones who think they are in monogamous relationships, are still testing positive. In fact more than half of all new HIV cases come from the primary partner. Maybe some of these good gays are not that good after all; maybe we should stop condemning people who choose a different lifestyle from our own; maybe we should all stop being so damn judgemental. Because PrEP can eliminate the difference between negative and positive. We can become a community that is no longer split by our HIV status.

Quite the opposite of being irresponsible, PrEP is taking responsibility for my own health and the health of those with whom I have sex. If that makes me a Truvadawhore, then so be it.

• Greg Mitchell is giving a speech about PrEP to the ‘European AIDS Treatment Group – meeting on new developments in prevention’ this weekend in Brussels.
• www.eatg.org

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