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PrEP: Why it’s not just for porn stars like me

Jason Domino, porn actor and sexual health campaigner, explains why he is on PrEP and why he wants NHS England to prescribe the medication to those at risk

PrEP: Why it’s not just for porn stars like me
Jason Domino
Jason Domino takes PrEP to avoid becoming infected with HIV

It’s been two years since I started doing porn, and two years since I’ve been taking PrEP (Pre-Exposure Prophylaxis).

I made my decision to take the medication after a scene I filmed with an HIV+ model. Although we used a condom, when I found out he was positive, I didn’t know what to think.

It highlighted to me that I needed to take ownership of my sexual protection. Back then I didn’t know that it’s almost impossible to catch HIV from someone with an undetectable viral load.

To be honest, I probably didn’t know much. I didn’t know that the oral sex I had given at the end of a scene only carried with it very low risk for infection. I stayed remained negative, but the experience stayed with me.

My first consideration in starting PrEP was that it would clash with the epilepsy medication I was already taking. As PrEP is not available on the NHS in the UK, there was little access to data on how the drugs would interact.

I found out it was likely to be safe by checking the details for Truvada (the branded name for PrEP) on the HIV Ichart app and website by the University of Liverpool.

The app list, which is created by medical professionals, if hugely informative and even includes interactions with recreational drugs.

‘Condoms will not be a solution for everyone’

Because of its lack of availability in the UK, when I began taking PrEP, I had to buy it from online source.

Thankfully, sites like iwantprepnow.co.uk now exist where sources are accountable to group reporting and testing. Prepster.info is great for updates on all the news regarding PrEP in the UK.

I found PrEP worked pretty soon after starting it. I’d had sex without a condom with someone and later in the same week they found out they’d contracted HIV.

He had a high viral loud and was in a very contagious state. We both thought we were HIV negative, but his most recent test prior to this couldn’t account for a recently-acquired infection. Tests have a window period when they cannot detect recent infections.

Condoms will not be a solution for everyone. Condoms can split and some men cannot sustain erections while wearing them.

Attempting to shame people who have sex without condoms is a failing strategy as HIV infection rates are increasing. HIV is a systemic problem and not isolated to individuals sexual health decisions. Fighting HIV needs a more comprehensive answer and can’t rely on individual’s last minute choices.

‘PrEP is the only protection against HIV for women that is fully within their own control: no negotiation for a partner to wear condoms is required’

The rise in HIV infections might be partially driven by us detecting infections more effectively and increases in testing. Regardless of this, it continues to affect too many people – and it’s not just the gay community.

Around a third of HIV infections in the UK are women. PrEP potentially plays a huge part in their future sexual protection. To date, PrEP is the only protection against HIV for women that is fully within their own control: no negotiation for a partner to wear condoms is required.

I take part in sex work feedback projects and I see the role PrEP has to play in protecting sex workers too. Many escorts don’t feel their lives are subject to lifestyle choices, and easier PrEP access would simply reduce existing risks for them and their clients.

Greater transparency in the prescribing of PrEP will uncouple it from chem-sex associations. Education and marketing also plays a part in this. The EU commission has licenced PrEP around Europe. It aims to join the US, Canada and other regions in becoming a pro-PrEP society.

In a post-Brexit UK, we need to remind the government that even on the current purchasing deal, it is cheaper for the NHS to offer PrEP than have a patient require HIV treatment for the rest of their lives.

The NHS is also able to negotiate bulk-buy deals, and the price of PrEP is likely to fall significantly in the next five years when generic equivalents become available.

Preventing HIV infection saves funding over time. Co-infection rates of Hepatitis C are higher for people living with HIV, so cutting back on HIV infection also cuts back on Hep C – another beneficial side-effect of PrEP.

‘Sensibly offering PrEP is an obvious option for us to drive down HIV infections’

Prevention starts at home. If you are frequently having sex consider having your Hepatitis A&B vaccinations. If you’re entitled to it, consider also having the latest HPV vaccination, as HPV can develop into cancer.

Test regularly; most other STI’s can be treated. Consider using protection. Part of your consideration should include PrEP.

Speak to your sexual health clinic for more information on all of the above. Sensibly offering PrEP is an obvious option for us to drive down HIV infections. There’s currently a survey online for people to make their views about PrEP known – you can complete the survey here, but the deadline is Friday (23 Sept), so don’t delay.

Jason Domino is a PrEP advocate, conference speaker, and international porn actor for film and stage. With an MA and BSc (HONS) Jason has now combined his education in art and science to campaign for better sexual health.


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