PrEP: Why aren’t you on it?

I’m a healthcare worker, Queer activist, and consider myself to be pretty well-informed and connected and yet if you had asked me about PrEP as recently as September, I would have wondered what you are talking about. I’m up here today because I feel that the word PrEP needs to be on the lips of every sexually active person and the people they love.

PrEP which stands for Pre-Exposure Prophylaxis is a once a day dose of an anti-retrovirus drug called, Truvada; which is also used for people who are HIV Positive to help keep viral loads low, but in people who are negative, if exposed to HIV, kills the virus before it has the chance to infect you. Numerous studies have shown it to be pretty darn effective.

Being newly single, and sexually active, this naturally piqued my interest; if a one a day pill can help prevent an unwanted condition, why wouldn’t I be on it?

But for good measure, I took to social media to see if anyone in my extended networks had any thoughts or experiences with it. The results were somewhat unsurprising, but worth breaking down:

Two people reached out to me privately to tell me their stories, which were well-received and appreciated, but I wondered why they didn’t feel safe to say publically they were PrEP users. Until I saw some of the other public responses (most of which were positive), but there were a strong current of people who were telling me that I weren’t being “sleazy” I wouldn’t have to worry about this or that they felt that this pill will encourage “bad” behavior.

This line of thought is nothing new…54 years after the Birth-control Pill hit the market and 41 years after safe and legal abortion was won, people are still saying that contraception will encourage “bad” behavior.

Well I’ve got news for them. “Bad” behavior does not need encouragement. At all. And furthermore, there is nothing bad, dirty, or shameful about sex. We owe it to ourselves, our partners, and the people we love to first and foremost, enjoy ourselves, but also to do everything we can to protect ourselves and other.

We as a society need to come to grips with the fact that sex-positive and queer-inclusive sex education not being a part of our public school curriculum is nothing short of a public health crisis; creating a layer of young people with lots of misinformation and questions who are afraid to seek out answers for fear of judgment. This is dangerous. Silence, in this case, literally equals death.

I, along with my Doctor, Dr, Chan, did decide that going on PrEP was the right decision for the type of life I lead. I was very fortunate to thus far not experience and of the side effects (nausea, vomiting etc.). And if you’re wondering, it didn’t encourage and more or less “bad” behavior.

To conclude, I would be remiss if I didn’t discuss how equally important access to this drug is to it’s availability. I am lucky in that I have a good job with good health insurance, so access to PrEP was no issue for me. But there are so many people in vulnerable demographics (I think of sex-workers and IV drug users especially) may not be as lucky and cannot afford to pay the over $1500 out-of-pocket cost of a monthly supply of Truvada. PrEP has the potential to make new HIV infections a thing of the past, but it cannot do that if no one’s heard of it and people who need it the most cannot access it.

These are the facts, but our challenge as healthcare providers, law-makers, activists, and people who want to see a world without HIV/AIDS is to overcome them. We have come so far already; research in tandem with activism has taken HIV for a death sentence to a chronic, but mostly manageable condition, and now we have the capability to prevent it in the first place. We need to be screaming about this from rooftops, flyering every gay bar, I also liked Dr. Nunn’s idea about using sites like grindr and scruff as tools for outreach, and also making the phrase “ask your doctor about PrEP” as recognizable a slogan as “get tested” and “know your status” is now!