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How PrEP Changed Gay Sex, Anecdotally

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So the topic of sex is absolutely fascinating to me, especially gay party/hookup culture in big cities. Anybody who has read my previous blogs can see that. I've been both a passive studier and active participant over the years, and I've gotten a pretty unique view of it all. A good friend of mine once said, "to understand gay men, you need to understand the messy emotions and politics of sex." Now I realize that my experience (and his) as gay men is very much ones that have taken place inside a bubble, unique to big cities with large, established gay scenes. And to limit this view even more, it's anecdotal evidence in the realm of a subset of urban gay men, mainly ones who are active in the party/gym/hookup culture. So take my observations for what they are worth, and I am in no way saying this is applicable to all gay men, or even most. I am simply speaking from experience within my own universe, which like stated above, is somewhat limited in scope. So with that said....

 

The rise in popularity of PrEP (Pre-Exposure Prophylaxis) has almost erased the fear of HIV/AIDS from the minds of many gay men who are sexually active with multiple people. When I moved to the city in 2014, before PrEP was really on anyone's radar, condoms were insisted upon for 90% of guys I talked to about hooking up. The other 10% who didn't insist on condoms were guys who probably already had it or didn't care. Either way, they were people regarded as ones you didn't want to go near, even with a condom. Fast forward a year, to summer of 2015. PrEP has now become well-known to those of us in the gay world, and more and more guys are going on it. It was around this time that I too began taking it. The problem with PrEP is that it is incredibly expensive. It's something like $19,000 a year if you pay for it out of pocket. Luckily I have good insurance, so it cost me next to nothing. You also have to go get comprehensive blood work/STD testing every three months by a physician. So at this point if you didn't have good insurance, it was totally out of reach. So PrEP became a drug only within reach of those with privilege (In America, how shocking:rolleyes:). I now started to notice that condoms were becoming less and less of the conversation about hooking up. Guys began asking if you took PrEP, and if you said yes, many of them would simply believe you and be willing to go bareback, even if they themselves weren't on it. This presents several serious problems. First off, the person could be totally lying and they may not be on the drug at all. Second, they could not be taking it every day, at which point the drug's effectiveness decreases dramatically. Third, it is only meant to prevent the transmission of HIV, not other STDS. And anyone who lives in a city knows that G&C spread like wildfire amongst gay men. 

 

2016 comes around, and many big cities begin offering the drug and the physician visits free of charge as a matter of public health. By the end of 2016, everyone I know is taking the drug, and 95% of the people I come across are also on it. If you open Grindr or any other hookup app, the vast majority of profiles indicated they were on PrEP. At this point, guys insisting on condoms were becoming few and far between, and bareback sex became the norm. The threat of HIV has been largely eliminated for those on the drug, and the other STDs are, for the most part, easily treated. I saw an article from the CDC that showed how STDs other then HIV spiked among gay men after PrEP became widespread, and that doesn't surprise me at all. 

 

I feel like we are returning to a pre-AIDS sexual culture in the gay world. For many, the fear of HIV simply isn't what it was in the 80s and 90s because of huge leaps forward in medical science. And for guys my age, we came of age in a time where HIV was a fading concern in the national discussion. Now with the introduction of this, that concern is pushed even farther back. Some worry about HIV adapting and becoming resistant to a drug like PrEP. So far, there has been only one confirmed case of a man catching HIV while taking PrEP correctly. I'm not a scientist, and don't have much interest in the science of HIV, so I can't comment on how legitimate of a concern this is. 

 

I want to leave my own opinions out of this for now. Sex in the gay community is both personal and political, and straight people so often fail to understand this concept and it's deep historical routes when looking as an outsider on how sex goes down in the gay world. So much of our community's identity and power is based around sexuality, and as men who still carry around the pains of growing up "wrong", we use it as a means to (at least try) achieve so much. 

 

Thoughts?

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Fascinating and dispassionate look at how the urban gay community has changed. I've told you before I see a lot of myself in you even with the 30-year difference in our age. I just paged through Scruff and most of the guys on the first page listed PrEP or "Treatment as Prevention" under safety practices. Living in an international resort town/gaycation destination, many of them are from other countries and they too claim to be on PrEP.

 

My doctor visits every three months include tests for the STDs we forgot about during the pandemic. We seem to have outbreaks of syphilis, gonorrhea, and chlamydia every few months. Is this the new normal?  I haven't been to a circuit/after/sex party in a very long time and I'm wondering if the little baskets full of condoms are still around. In the end, it comes down to personal responsibility as it always does.

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The dangerous thing about prep, to this old school boy, is the misguided belief that bareback is suddenly an option.  Yes I'm happy that PREP is a viable precaution to the death sentence I grew up with in the late eighties and throughout the nineties.  Suddenly the waking horror I lived through and many of my friends did not is a contained threat.  The I don't care about you attitude of the Regan years and the don't ask don't admit scare of the Clinton era is to my chagrin long forgotten by the I'm just discovering my path of sex in the controlled world of PREP so safe is an option where I can go bareback because at least I won't die 

HIV is not the only worry out there... Nor is the other STD a young gay man might contract by letting multiple humans inside so to speak.  It's about the responsibility and the accountability a gay male must navigate as he approaches his sexual existence. 

I am an admitted promiscuous gay male that had my share and your share of risky fun with too many partners to account for.   Yes I was always safe...yes the threat of HIV was always on my mind...but so was the threat of all other STD's.   I never wanted to have to tell my life partner that I had herpes, or any of the other STD's out there because I was foolish with my body in a search for instant gratification.  

I have friends who are living with certain sexual diseases that have a hard time finding that life partner because of stupid mistakes in the past.  Good for you that you don't have a life threatening disease, but yet a life long disease and one that is spread through unprotected sex still makes the search for the one harder to achieve. N

Currently I am enjoying a condom free life with my partner because over our life we made smart choices in regards to sex.  We can achieve the perfect Union because we were protected until we found the one that was the last one we would ever need to worry about it.

dont forgo your future for a brief interlude knowing that at least you won't die for sure but run the risk of a "i have this for the rest of my life and will always pass it to the one I love" .  

Be safe, be smart, and don't get pressured or lulled into a false sense of security because I take a pill that assures me that at least I won't get the  dreaded AIDS but I can still get a life long nuisance that could ruin my chance at finding life long happiness.  

 

My my two sense.  

 

J

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