Joining the UK-based PROUD study for PrEP over a year and a half ago was honestly one of the best decisions I have ever made.
As part of the study I take one pill of Truvada every day and as long I keep doing this – like clockwork, before bed – it offers me near complete protection from HIV.
It wasn’t an easy decision; I remember hearing about the study and thinking that it was a great idea … just not for me, obviously.
I knew my stuff and my condom usage was, well, pretty good, mostly – let’s say nine out of ten. The problem was this meant every three months or so I’d find myself in the perfect storm of being too inebriated and stuck with a smoking hot, super hung guy who just wasn’t that keen on using condoms.
Before you know it, you’re back in A&E on a Saturday night, avoiding making eye contact with the guy with the bleeding nose and counting down the hours while you’re waiting to get PEP (Post-Exposure Prophylaxis).
I was pretty ruthless with my PEP policy; if a guy told me he (thought he) was negative I’d still march myself off to the clinic or hospital.
To some degree, this tactic must have worked, as I’m still negative now, but it didn’t feel sustainable. I was constantly beating myself up for having to go on PEP again. The withering gaze of the health advisor’s didn’t help, while the suggestion that they introduce a loyalty card went down like a lead balloon. It really put a huge shadow over my sex life.
That’s one of the strange things growing up gay; HIV becomes bound up in your sexuality and sex life in a way that it feels hard to get away from.
There’s a constant sense of doubt and fear: what about that time the guy was rubbing his cock on your arse – was there any pre-cum? Did I have that cut lip before I gave that blowjob? Why are they taking so long to call me for results? I feel like I’m going down with flu … wait, is it just flu?
Every trip to the clinic felt like spinning a roulette wheel wracked with anxiety – lucky this time, but maybe not next.
This was all until PrEP. It took a while for it to sink in, but as the evidence mounted from the various clinical studies, and as I successfully took my daily pill, easily, and unlike condoms, with near flawless adherence, I finally felt something change; I felt absolutely in control and confident about my HIV status.
When I go for an HIV test now, which I do every three months, my heart no longer races while I wait for the dot to appear on the rapid test. I’m no longer running a secondary narrative on my head during sex about, ‘what happens if he doesn’t put a condom on; is he going to?’, and even if I don’t use one, I still feel absolutely confident that I’m protected, and so are my partners.
I no longer worry at all about having sex or dating guys living with HIV. In fact it’s actually easier as they tend to be a bit more rational about HIV – and me being on PrEP and them being undetectable makes it about the safest sex for HIV imaginable, in practical terms.
It’s hard to describe, but for me, PrEP has given me the confidence to finally beat HIV, and the shadow it left over my sex life, in a way that condoms never quite managed.
I haven’t picked up any other STIs since being on PrEP (ironically I had chlamydia and gonorrhea in my throat in the year before starting PrEP – so go figure). If I did though, getting tested every three months means I’m much more likely to get them treated quickly and not pass them on to any partners – my PrEP appointments help me stick to this without fail.
For some of my friends, they use condoms 100% of the time, and that’s great. Over the years though, I’ve watched far too many become positive, and they all knew about condoms, and about PEP, but for some reason this wasn’t enough.
I feel lucky and almost guilty that PrEP came along quick enough to make a difference for me, but I cant help but think that if PrEP had been available, how many of them would still be negative?
One friend was on the deferred arm of the PROUD study (meaning he had to wait a year for the meds) and he became positive while waiting for PrEP. It feels ridiculous that we have this tool that we know works, and the longer we withhold it, the more HIV infections that could have been prevented, will take place.
Terrence Higgins Trust are actively campaigning for PrEP on the NHS – ‘Stop HIV. PrEP now’ and almost all of the charities working in the HIV sector have signed a community statement calling for NHS availability.
If you’re reading this and thinking that PrEP might be right for you or a partner, then helping fight for PrEP on the NHS is a no-brainer. Einstein once said the definition of insanity is doing the same thing over and over again and expecting different results, and this is true of HIV prevention as much as anything else.
If we really want to look to a future when gay men aren’t bearing the brunt of HIV in the UK then we need to embrace new approaches and tools like PrEP and use the support, understanding and activism of the LGBT community to make this happen.
PrEP has helped change my life and I believe it could make a massive difference to stopping HIV in our community. Please talk to your friends, your doctors at the clinic, and join the Stop HIV. PrEP Now Facebook page, and find out more about the campaign and how you can help at tht.org.uk/PrEPnow.
The writer of this article asked to remain anonymous