Name of interviewee: Alex
City of residence: Queens, NY
When did you start taking Pre-Exposure Prophylaxis (PrEP)?
3 years ago
How do you think guys on PrEP experience sexual pleasure?
PrEP is coming into at the same time of social media apps. Hookup culture is really at its zenith. I know from my interactions in those apps that people are taking it as a free card to forego condoms. Most of the time, not always. That doesn’t mean they’re being careless. Before people tend to sero-sort. Match negative and negative, positive with positive. Now I see like a tagline… Of people saying I’m on PrEP, and you know what that means: “Wink wink”. I have mixed feelings about that. There is still reason to be cautious without a doubt, but at the same time there is a part of me that is happy that people are feeling empowered to live the sex lives that they want without fear and oppression. I realize that just by talking about sex and sex practices, that alone is pushing people into light and people are being more health conscious because there is a dialogue. Secrecy just leads to more secrecy and it’s harder to take of yourself hiding in the dark.
There is this term which is probably the most explicit that you can be in the gay community: a bareback cum dump. I kind of like this idea: if that is what you want, by all means you should be able to achieve that. If that is what you need to get off, you should have the right to be able to experience that and it is amazing that now you can do that without worrying so much.
How have your sexual relationships and sexual pleasure have changed since you are PrEP?
My relations have grown up a little bit. They have matured instead of beating around the bush, or being naïve or secretive about it. I’ve become more frank and practical. I guess if I was going to engage with a partner, there could be a franc discussion about being HIV negative and on PrEP.
Being on PrEP has opened the door for me to start exploring different things and what I like. I’m not sure if I have been able to define what those pleasures are per se, but it has allowed me to start exploring more and figuring out who I am as a sexual being.
I think nobody is perfect and that’s why PrEP is taking off, because people did not make the best decisions all the time before, so it makes sense to have that extra back up in certain cases. People are just doing the same or more of the same but more confident and freely, with less stigma and shame. I think in a weird way we are kind of growing up as a community because we are now more open about talking these kinds of things.
How do you think PrEP can influence intimacy between two men?
There are a lot of understood implications when you openly say to each other that you are on PrEP. It is the idea that being on PrEP means that you can go condomless. It is childish in a way to pretend that it is not the dialogue that happens. It is unfair to say that people taking PrEP are still expected to use condoms 100% of the time, because why would they risk toxicity or some side effects? When you openly say you are on PrEP, it’s not like black and white. There is a dialogue that can take place about condom use and other methods of risk aversion.
You develop intimacy not necessarily through physical actions but through the words you choose to express yourself, your feelings, your desires. Just having that discussion of being “This is what I want, is that what you want?” That is how you build intimacy.
How do you make the decision of whether or not to use condoms now that you are on PrEP?
To be franc, for me it is a case by case situation. I wish I could tell I use condoms all the time but that is not who I am. A lot of factors come into play and I do make certain assessments about possible sexual partners. I try to make “ignorant” assessments about what their practices might be. For example, if I feel that someone gets into party and play (PNP) or things like that… Not to pass judgements, but when you bring drugs into the mix it is very health risky, then I decide I should use a condom in that case. Or someone is HIV undetectable and has papers that show that he takes care of himself, this might be a situation in which I might feel comfortable not using the condom or taking the risk. It’s really on a case by case basis and then none of it its full proof. But it is just important that I’m more aware of the risk I’m taking because I get into a thought process and when I feel that I do take risks I have a dialogue with my doctor as soon as possible.
What type of conversations have you had with your health provider?
I have been able to find a doctor with whom I have felt safe, and I have been open and franc with. That has allowed me to pull back on this need to be emotional when I discuss these things. It’s more like a business transaction. These are the facts, give me the information I need so I can take better care of myself. Being able to have those discussions with the doctors has made me feel more empowered, has allowed me to understand that sexuality is part of who I am. For you to be on PrEP you have to do your 3 month-check ups, you build a relationship with your doctor and you become more health conscious. All of those things are empowering actions and feeling empowered in one thing tends to lead into feeling empowered in other aspects of your life. I can relate to just feeling more confident as a person or more empowered in my own skin.
What is the stigma that you see around PrEP?
Initially that term that came “PrEP whore” referred to the idea that PrEP would only encourage gay men to go barebacking all over the city, which probably was happening already. That was my first exposure to stigma on PrEP, when people had that debate on Facebook. They were not saying “this is a groundbreaking thing, an improvement in prevention for HIV”, it was more like: “This is just going to let people be whores”.
It’s kind of heartbreaking for me that in this kind of historical moment of this practically miracle drug we have, we are going to use it to start shaming each other. That inspired me, once I was on it, to be more vocal about promoting a different dialogue about it: “Look, we have another way to stop this thing”. And I think now that the discussion is shifting in that direction…