No More PrEP Shame

Having sex is not bad.
Taking an HIV-preventative medication is not bad.
Getting a sexually transmitted infection is not bad.
Not talking about it is.

LGBTQ people are often raised with a tremendous amount of shame around their gender and sexuality. I spent years in the closet, petrified of how my friends and family would react. On top of that, many of us have an immense (and justifiable) fear of HIV. Fortunately, for many people at-risk of HIV, PrEP/Truvada offers a reprieve of these fears. And in that freedom, many have been able to explore their sexuality and overcome sexual shame.

If you haven’t been privy to the term “Truvada Whore”, it is is both an attempt to reclaim sexual freedom through the drug as well as to denigrate sexual promiscuity, particularly among the gay community. As gay men have more condomless sex and sexually transmitted infections (STIs) increase, we continue to internally scapegoat PrEP/Truvada rather than discuss deeper culprits.

Deep cultural shame around sex prevents us from addressing a solvable problem. We’re more than willing to talk about testing and vaccination for measles, but as STI rates climb by double digits, we are simultaneously slashing community testing budgets. 50% of people under 25 get an STI and there are over 20 million new infections every year, and instead of deploying proven solutions, we place the onus on symptomatic patients to find (likely shaming) care and to notify their partners.

When kids have lice at school, do we expect our teachers to shame them as a preventative strategy from unknowingly coming into contact with lice again? Do we ask the child or parents to call down the phone tree and hope everyone seeks care? Absolutely not; that seems ludicrous. And yet, when societally internalized shame around sex comes into play, we act in that ludicrous way.

Should we use condoms? Sure. Is that approach going to properly address our record level of STIs? No. Neither will shaming people for having sex, in fact research shows that’s just going to result in riskier behavior. We can’t expect the government to solve this either, because frankly they don’t have a great track record of getting things done these days.

Instead, the first step is accepting that sex is good, and natural, and fun. That having sex carries some risks and that talking about those risks with our partners is okay. That getting tested and talking about our statuses is mature and can lead to better sex in the long run.

I’ve been a pretty big whore at times. Anybody that knew me when I moved to New York can attest. It was a blast, and I've learned not to make apologies for it. I got throat gonorrhea and penile chlamydia along the way, but I get treated. And thank all the stars in the sky somebody dragged me to their doctor and got me on PrEP throughout it all.

PrEP helped me get over my years of internalized homophobia and fear around sex. Getting STIs was always shameful and sucked to tell people, but I came out of it okay in the end. In the end, I’ve learned that if we aren’t willing to look after our own community in a shame-free way, there’s no chance that others will.

Next time you see a meme about gonorrhea, chlamydia, and syphilis coming down the hotel hall for the person on PrEP, like it, cuz it’s funny, but know that it doesn’t have to be shameful. Thankfully PrEP patients are regularly tested and can get treated before passing on infections. The real shame is in hiding from the truth.

Moral of the story: have sex and get tested.

If you don’t know where to get tested, feel free to reach out to me.
brad @ kalamos dot care


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