3 min

To take PrEP, or not to take PrEP (Part 2)

A pill seems a small price to pay

Credit: Mike Miksche

My doctor had been against me taking the drug because of how serious the side effects can be. He asked why I’d want to take a pill to remain negative just so I wouldn’t need to take a pill if I became positive. “It’s a pill for a pill,” he said. PrEP doesn’t offer full protection against HIV, so in actuality, the fantasy I had of becoming the city’s most notorious cum-hungry bottom wasn’t feasible.

So if PrEP isn’t the start of some sexual revolution, what are the benefits? With HIV, one can still live a long happy life, have great sex and, with an undetectable viral load, not pass it on to others. So is it all just the stigma? To me, it felt that being positive would jeopardize the thing I value most in life: the opportunity to connect with people without fear of discrimination. I’d heard stories from positive friends who’d been rejected by one guy after another simply because of their status, all out of ignorance. Taking a pill seemed like a small price to pay to avoid such things.

Whenever I’d get tested, no matter how safe I’d been, I’d play games of “What if?” What if I was so drunk I forgot to put on a condom, what if that weird guy who I should never have slept with slipped the condom off when I wasn’t looking, and what if I’m that one person who gets HIV through oral sex? Is that even possible? And can you get it from swallowing cum? What if you have a canker? Is low risk really just no risk, but rather a doctor creating a fear to avoid liability? What is the damn truth?

Then I’d start thinking about my family and what they’d think. Would I even tell them? Probably not. They had a tough enough time with my sexuality. Would people discriminate against me at work? What friends would I tell? Would they just feel sorry for me? I hate being pitied.

“I’m single,” I told my doctor. “The thing that worries me most is the stigma, especially since I’m single.” To my surprise that’s all I had to say. He backed off and actually sympathized with me, defending my situation. I got the prescription right away. A few weeks later when I returned to his office to review the results of the blood test required for the medication, I had had a change of heart. Despite my fear of the stigma, I’d concluded that I’d been safe for years and it seemed to be working. Why add a new drug to my body that could potentially cause complications? This time my doctor was the one insisting that it was a good choice for me. “A fair percentage of gay men in Toronto are positive,” he explained. “If the medication is covered by your benefits, there’s no harm in taking it.”

At the play party several days later, I wonder about the status of the two guys I’m with, but it’s not the sort of place where you ask people. And it really doesn’t matter; over the years I’ve learned to be safe, regardless, and treat everyone like he’s positive.

The boy with the spiky hair disappears after coming, so the man with the beard and I start talking. He tells me his name is James; he is a banker from Toronto and he lived in Barcelona for a few years. I tell him that I lived there, too, and we start naming the neighbourhoods we lived in and our impressions of the city and its people.

I can tell that he is a pervert just like me and wonder whether he is finding the journey as lonely as I am. During our conversation we kiss a little more, then he asks if I want to go home with him. Of course I do. As we are about to grab our jackets, he confesses that he is HIV-positive but undetectable. “Do you still want to come back with me?” he asks.

In all honesty, I am reluctant. I haven’t started PrEP yet, so it won’t protect me. But protect me from what? I am always safe anyway and he is undetectable. What does this drug really do? “Yes, I do,” I say.

“Really?” He seems surprised.

I don’t ask, but on the walk to his place he says that he isn’t sure how he got the virus and describes the entire thing, jokingly, as a “murder mystery.” I laugh and follow him. Perhaps the sexual revolution has already started but we’re too blind to see.

<Previous: To take PrEP, or not to take PrEP (Part 1) >Next: Searching for a daddy (Part 1)