Magazine Upfront PrEP, discrimination and HIV stigma By Mario | @Londondiaries2 Every day in the UK, about 10 gay/bisexual men are diagnosed with HIV. About 11% of HIV-positive gay men are on meds but not undetectable. You would think that these figures alone would help the NHS gods see the light and work towards an end to the PrEP saga. Unless you’ve been living in isolation for the past year, by now you will know that there is a pill out there which, if taken daily, within seven days can prevent you from catching HIV if you were to have unprotected sex with an individual who is HIV-positive and has a detectable viral load. I am all for PrEP. Besides being cost-effective, PrEP is an outstanding preventive tool and should be freely available to anyone needing it. However, we should be careful not to turn PrEP into a way for us not to take responsibility for our actions, because there are many other STIs out there. Having said that, the smear campaign by some of the British press is not only despicable but also highlights how we still have a long way to go. As a nation, when it comes to equality, gay rights and HIV, and in certain circles is still reminiscent of the horror stories of the past. PrEP would take up to 0.2% of the NHS budget, a drop in the ocean. HIV in the UK affects mostly gay men, transgender people and ethnic minorities. Financing PrEP probably wouldn’t be an issue if it were our heterosexual counterparts needing it the most. Thanks to the many improvements and discoveries in HIV prevention, these days we only have two categories of people who can transmit the virus. We have those who haven’t tested in a while and believe they are HIV-negative when in fact they are not, and we also have HIV-positive people who are not taking or not responding to their medication and whose viral load is detectable. Take the time to read the paragraph above carefully and if you are still unconvinced, do some research of your own. Knowledge won’t harm you. Knowledge will help you make an informed choice about the kind of sexual activities you wish to indulge in, while being safer. This is also the responsible thing to do. HIV-positive individuals shouldn’t be looking after the rest of the world. HIV-negative people should be mature enough to take care of themselves, or at least to do their homework. Knowledge would probably help part of the HIV-negative community to drop the passive/aggressive discriminatory attitude projected on to HIV-positive people since the early days of the epidemic. When it comes to HIV, stigmatisation and discrimination are rife in gay-land, now more than ever. Sharing an HIV-negative status on a hook-up profile as a scarecrow for the ‘less fortunate’ is rather uncool. With knowledge, we should realise that if we wish to remain negative and casual, bareback sex is all we truly want, then our only safe option is to be with a man who has disclosed h=is HIV-positive status, is on medication and has an undetectable viral load, while taking PrEP ourselves. But let’s be real here. No one in his right mind would choose to take medication for the rest of his life, unless it was strictly necessary, as any HIV-positive person will confirm. When the PrEP fiasco imploded in the hands of NHS England, I didn’t truly buy into the outrage coming from certain areas of the gay community, or how suddenly people who have never been involved or cared before, jumped on the ‘let’s fight HIV bandwagon’. It simply didn’t add up. Then I asked my best friend what he thought about PrEP, and his answer said it all: “Honey, I have been dying to get a big fat load up my arse for years!” No false pretences, the truth finally out there, at least between us. As colourful as his statement sounded, this is exactly what some gay men secretly want, either because we crave a skin on skin contact, which subconsciously we associate to intimacy, or simply because once upon a time before the HIV epidemic, bareback sex was the norm. Back then, there was nothing ‘dirty’ about unprotected anal sex. As it seems, we all crave what we can’t have. It’s human nature. PrEP is not about eradicating HIV/AIDS from the world, or ending stigma and discrimination, at least not for your average gay man. If this were the case, we’d have thousands of people chaining themselves to the railings outside Downing Street demanding better medication for all in Africa. But we don’t care about Africa, do we? All we want is to have a good fuck. Most tellingly, HIV-negative men are simply scared of catching HIV. HIV is “DIRTY”; HIV will turn HIV-negative men into “cum scums” overnight, because this is what we associate with HIV: the shame, the forbidden, and the sleaze. It’s amazing what fear of being marginalised does to someone’s senses and ability to process information without freaking out. I have lost count of the number of men who have told me that they had no problem with my positive status and yet disappeared from my life in a rather unceremonious fashion within 48 hours of my disclosure. This is the main reason why many men with HIV, who are healthy and in a stable condition, won’t disclose their status unless they are asked, or feel there may be a future with the person they’ve had casual sex with. They simply wish to avoid unnecessary dramas and the psychological turmoil that a rejection due to their HIV-positive status would generate. I came out as a gay man. Then I came out publicly as HIV-positive more than once over the years, simply because I wanted to raise awareness, and because I felt that in order to fight stigma and discrimination I had to put my face and name out there, unashamed of my status, as I have always been. These days I only discuss my status in private with people who I feel I have a connection and I want to know better. My casual encounters don’t need to know because they can’t catch HIV from me. I have HIV antibodies in my blood. This is the only difference between a negative person and me. Those antibodies won’t do anything to anyone, or me for that matter. Knowing that I cannot harm my sexual partners means everything to me, and it means the world to the majority of HIV-positive people out there. This is why PrEP should be free for all, no questions asked. It shouldn’t matter why people wish to use PrEP, but apparently it does. For a large circle of negative gay men, PrEP is about sexual liberation. It’s as simple as that, and I wish we’d drop the hypocrisy from the equation. PrEP equates to a perpetual morning-after pill. As crude as it sounds, chunks of the gay community simply don’t want an ‘unwanted child’ (and rightly so…) after being “DIRTY CUM FUCKING WHORES”, because in their private lives, that’s what quite a few people feel they are. I don’t see this as a problem in the straight world, so why are we judging our own? There is nothing wrong with being sexually active. What’s wrong are the hang-ups that we still have about certain sexual activities, a consequence of over 30 years of bad press surrounding HIV and the activities we associate with it. Your average Joe won’t admit he likes bareback sex because this would lower him to his HIV-positive brother’s level, because ‘this is how you get HIV’. Not only that. It would associate him with them and their “DIRTY LIFESTYLE”. People might even assume our average Joe is positive when he is not: the shock! The horror! I have learned the hard way that these days discrimination comes nicely packaged in words and phrases, such as “CLEAN” and “DISEASE FREE”. You see, I don’t normally use capital letters. In this instance though, the CAPS function has helped me highlight how some HIV-negative men have addressed me over the past nine years, when safely hidden behind a screen, of course. This kind of behaviour is vilifying, is cowardly and wrong, and it simply has to stop. With or without PrEP, our community will remain divided, unless we change our attitude and learn how to accept and respect each other regardless of our HIV status. What is PrEP? PrEP stands for Pre-Exposure Prophylaxis. An HIV-negative person takes pills (developed to treat people with HIV) regularly to reduce their risk of HIV infection. Several studies show that PrEP works. PrEP is currently only available in the UK by private prescription, online and from some sexual health clinics and GPs. Why do we need Prep? Due to the high rate of HIV infections, there is a particular need for the NHS to make PrEP available to gay men. However it should be available to all people who are at high risk of acquiring HIV. INFORMATION ABOUT PrEP: visit www.gmfa.org.uk/prep. FURTHER INFORMATION AND WHERE TO BUY PrEP: visit www.iwantprepnow.co.uk. INFORMATION ON HIV TESTING: visit www.gmfa.org.uk/hiv-testing. THIS ARTICLE WAS TAKEN FROM FS ISSUE #156. TO READ THE ISSUE IN FULL CLICK HERE. All opinion articles in FS are the opinion of the writer and may not reperesent the views of the magazine, GMFA or HERO.