Name of interviewee: David
City of residence: Brooklyn, NY
When did you start taking Pre-Exposure Prophylaxis (PrEP)?
How have your sexual relationships and the way you experience sexual pleasure changed since you are on PrEP?
I can’t say they have changed. I am a little bit more confident and comfortable in the dating scene. Before I was not meeting people at all because I was worried that one accident, one slip up could be a problem. On PrEP I am a little less concerned at least with the HIV aspect of it. In terms of receiving and giving oral pleasure, I am probably more open to it than I was. Other than that, I don’t think I have changed much. I still practice safe sex.
Do you have friends who are on PrEP? If so, have you talked with them about how their sexual relationships changed because of PrEP?
Yeah, and they vary widely. My friends think similarly: It is better to be safe than sorry, but there are people that I have met in apps or bars, who think that [PrEP] is a safety net for everything. They practice barebacking and do whatever they need to do and feel perfectly comfortable in doing that just because they are taking PrEP and you have to explain to them that PrEP is for one thing only. It doesn’t protect you against everything. Some people seem to have deemed an opened door policy; they hear is it’s just a free ticket to have bareback sex. And that sucks.
How do you think that other people experience sexual pleasure while on PrEP?
I know people who were more afraid of barebacking. And now they are more open or cavalier about doing it on PrEP. In terms of opening myself to other experiences because of PrEP, I haven’t really changed. As I said before, I don’t necessarily trust the other person, even if they claim they are also on PrEP. I don’t change what I am doing for that. Now, if we are talking about a monogamous thing, a situation when you are dating someone and you can go and get tested together, I would probably be more open to trying things that would be deemed risky… With someone I love and trust, PrEP would make me more open to even just a suggestion of it.
Is there something thing that has changed in the way you select your partners now that you are on PrEP?
Probably that I am not too concerned with anyone who identifies being positive. Before, PrEP I would notice it, weigh my options and decide carefully thinking how attracted I am to them. When they declared themselves HIV positive, in the past I wouldn’t have trusted myself to do it. In a drunken heated night, who knows what can happen, we all have had those moments. Now that I’m on PrEP, the HIV status of a possible partner is just like their hair color, height, weight, those things are just part of who they are and it doesn’t affect my decision on who I want to be with or not.
How do you think hooking up has changed for other guys who are on PrEP?
There are some who are going to bareback regardless and, now on PrEP, they are more confident doing it. I feel, personally, that not everybody who claims to be on PrEP is on PrEP. Some are saying it to be more appealing for other people to bareback. I just happened to know one guy who did that. At one point he took PrEP, his prescription ran out but he decided to keep it because he only does bareback. I chatted online with him about this and no matter what I told him, he kept throwing excuses on why he liked to do it bareback. In the end, he admitted it: I just like doing bareback. I ran out of PrEP, but I still like doing it. That kind of behavior is what PrEP fosters, inadvertently though, not directly.
How do you see PrEP in the context of guys who use drugs for sex?
I think they are unrelated things. I think people who are into chemsex are going to do it, regardless of whether they are on PrEP or not. Someone whose desire and drive is to get high, my instinct says they are not thinking about PrEP. I’m pretty sure they take their ecstasy or their LSD more than their PrEP.
How do you think PrEP can influence intimacy between two men?
In monogamous relationships sometimes you get to a point in which you don’t want to use condoms anymore, but there are still fears on the back of the mind. I personally have friends whose boyfriends have done things secretly, come back and made their partners positive. PrEP alleviates at least this particular fear. Most people, including the PNP (“Party and play”) crowd, are not thinking gonorrhea, they are not thinking herpes… their biggest nightmare is HIV. It is on everybody’s minds. PrEP basically clears the way for a more intimate relationship in that regard.
How do you make the decision of whether to use a condom or not, now that you are on PrEP?
Nothing has changed for me, I still use condoms all the time. I’m not perfect, I admit there have been moments when the partner I was with ripped it off essentially because he wanted to give me oral and in the heat of the moment, he hopped on and I’m like, “Oh Shit, stop,” and he was like “Don’t worry – I’m on PrEP”. And I’m like, “Well I’m on PrEP too” and kept going, even though my brain registers there are other things besides HIV. If I know I’m going on a date that night, I’m always using a condom. I don’t worry too much about HIV after those incidents, but the other stuff is the first thing I’m thinking in the morning and for the next two days, I try to take some time off, go to the clinic and have a quick test.
How do you think other guys who are on PrEP decide when to use condoms?
I feel that most of them decide based on their partner’s attractiveness; just because they think a guy is hot, they think he is safe. Also, when they are talking to each other, they decide if that person is more likely or less likely to take risks. “So maybe I will use a condom with him, maybe I won’t, or maybe I won’t feel bad if I don’t…”
Have you been able to talk openly about your sexuality with your provider?
My provider is pretty good. She is not going to go into a full conversation about it, but when I did go to an examination and asked her if I could have STD tests, she got me into talking: “Are you single, married, you have sex with men or women?” And no matter what my answer was, she did not have a reaction that made me feel in a certain way at all. And from that first interview two years ago, I have been able to talk about everything. She asks me questions and I openly answer, because in my opinion, if I don’t answer correctly, she can not help me the best way she can. The only issue is to get an appointment with her. It can be months… PrEP can run out and I have to wait two or three months until I see her again. So I have to interrupt certain periods of time and then re-start. That is my biggest barrier, I don’t have a provider that is easily accessible. The appointments are just difficult to do, and sometimes they fall out.
Do you think there is a stigma around PrEP?
That you automatically want to do bareback and that you are a slut. That is the stigma. The questions on Grindr that I get are like: “Oh, so you just like doing bareback?”, and I’m like “How do you think that even computes, do you even understand what PrEP is?”, and that becomes an educational conversation. Somehow PrEP has been misconstrued into this slut shaming kind of thing. Education is the only thing you can do as remedy.