PrEP Stories: Steve

My journey with PrEP has been both a personal journey and a journey I’ve taken with the community around me as we all approach this new HIV risk reduction strategy. PrEP changes not only how I view sex and HIV but it also has the potential to change our community and our relationships, let’s make sure we change for the better – we face a bright future as gay men in this country, as long as we work together.

I knew PrEP was right for me because I knew that I needed more ‘tools in my belt’ – as the old line goes – to avoid HIV transmission. It’s no secret that I love sex, I love the intimacy, I love the passion, I love forming connections with incredible men. But I couldn’t rely entirely on strategies such as undetectable viral load in HIV positive partners or condoms.

The research on undetectable viral load speaks for itself; it’s a very reliable HIV risk reduction strategy. But with regards to condoms, so much happens in the moment of sex; whether you and your partner are affected by alcohol or drugs, whether condoms are accessible in the moment or simply the passion of the moment can mean I can’t rely on condoms to protect me 100% of the time. Women got the pill for this reason, so that they could take responsibility for their own fate, the only person they need to rely on is themselves – we now have this opportunity.

So much happens in the moment of sex… I can’t rely on condoms to protect me 100% of the time

I can have sex all day and all night (let’s be honest I don’t have that sort of stamina, but for argument’s sake…) and I just need to make sure I have my pill, and with this I can have the sex I want to have but without the anxiety of HIV transmission hanging over me.

Condoms work for most guys, but for many of us condoms don’t work or aren’t used for a variety of reasons – but the reason is irrelevant, this is a health issue not a moral one. Moralising around sex and HIV prevention within our community has the potential to be toxic – so as long as you’re using the tools that work best for you to prevent HIV transmission, be very proud of what you are doing.

For me, it seems that taking my daily blue pill with breakfast is so easy, and it effectively removes my risk of HIV transmission. It’s really so simple and it works – in all of the PrEP efficacy trials around the world, not a single person has contracted HIV when taking PrEP as prescribed.

I’ve gone from looking after my own health to advocating for the health of my entire community because I truly believe that we can achieve no new HIV transmissions by 2020. We have under five years guys, condoms have got us to a great point today, but we’ve been crying out for something more, something for the guys who are at higher risk of transmission, and we know that PrEP will protect you and your community from HIV transmission.

I’m always asked, “but what about other STIs?” And I assure you none of these people suck dick with a condom on, so I ask, “what about oral gonorrhea!?” Or the plethora of skin-contact STIs that can be contracted from the unprotected base of a dick or surrounding areas?! Yes, we need to be aware of STIs, and yes we absolutely have to get tested at a minimum every three months. But to argue against the most effective HIV risk reduction strategy we’ve seen (other than abstinence) that will save many, many gay men from seroconverting? Let’s keep it real. If you have sex, you’re going to get STIs, it’s a natural part of the human experience, we need to be aware but not afraid, they’re all treatable and I think effectively removing my risk of HIV transmission with PrEP is a pretty great thing – in fact, it’s a game changer.

Most importantly, we need access to PrEP. Importing it off-label from overseas is accessible and affordable only for some of us – for many of us it is out of reach and unaffordable. We need to get serious about getting PrEP onto the pharmaceutical benefits scheme (the PBS) so that we have equal access for all Australians that need it. The economic argument against PrEP simply doesn’t add up; access to PrEP during a sexually active period for an at-risk individual provides a huge saving over providing anti-retrovirals for a lifetime if, but this argument should make us all a bit squeamish; we’re people, not an economic burden.

This is the development that the gay men who lost their lives to the epidemic would wish they had. PrEP is the closest thing we have to a vaccine, it’s our daily pill, and it will get us to the end of HIV if we all do our bit to reduce our risk of HIV transmission and get tested and treated often.

PrEP works guys – we may not all want to go on it, but we all need to get behind it; let’s get it on the PBS, let’s be the first place in the world to see the end of the epidemic, we can do this.