Last week a group of leading HIV charities released a joint statement outlining their position on PrEP, Pre-Exposure Prophylaxis. Essentially it is a ‘new’ HIV prevention method and causing quite a stir amongst the HIV community. Medication in the form of a daily pill is given to HIV negative people who are at high risk of acquiring the virus, for example gay men who regularly have bareback sex. Currently it’s still under trial in the UK via the PROUD study which is looking at its effectiveness amongst MSM.
There are a lot of opinions as to whether PrEP is a good thing or not, I know on the face of it anything that has the potential to reduce HIV infections sounds like a good idea, but I have some concerns.
Firstly I don’t think we are delivering the right message if we’re saying to high risk groups, ignore the fact you’re indulging in practices that risk your own health, we’ve got a pill that can probably fix all of that now. Condom use must be pushed and we need to assess why the message of its importance is struggling to get through to more people. Why are we living in a society that encourages people to forgo any responsibility for their own actions? People don’t think of the consequences of what they’re doing when there is an easy way out, and that doesn’t just put themselves at risk, it puts others at risk as well.
Secondly even if this can help to control the spread of HIV, it isn’t going to do anything about other STIs or harmful viruses such as Hep C. I know many people think of HIV as ‘the big one’ but other STIs can cause considerably more damage to someone’s health, both mentally and physically. It’s not just HIV that is rising amongst high risk groups, and sexually transmitted diseases often travel in ‘packs’, there is no point offering protection to one whilst doing nothing about the others.
There are a growing number of communities on Facebook and Twitter supporting the bareback lifestyle, I’m not going to sit here and judge people or try and start an argument with anyone who wants to involve themselves in those behaviours, but it does make me anxious to know that thousands of young men are actively promoting bareback sex. Peer pressure isn’t confined to schools and groups of young people. Young and old men and women alike need to have the confidence to make their own decisions about their own bodies and their own health.
And has anyone thought of the consequences to signing someone up to PrEP and then a situation arises where they don’t adhere to the medication, or the virus still manages to infect them and takes hold in their body, what are the upshots to a person’s mental health and self-esteem if that were to occur, and who is deciding who is fit and mentally capable of dealing with that potential scenario.
Mistakes may be a ‘portal to discovery’ but HIV is one mistake in my life I wish I hadn’t needed to deal with. I was young and naïve and didn’t think about what my actions could lead to, and as long as I am still able to I’ll continue to remind people of this.
Make your own choices, but be PrEPared for any outcome.
Alex Sparrowhawk 
For a long time I had the same concerns as yours about PrEP, but I have come to term with the realisation that PrEP is not, and will never be for everybody, and that it will certainly not be about replacing condoms or promoted as such (as for the charity’s statement it is pretty much inconsequential).
The reality is that some people do not use condoms consistently for a broad range of reasons, and that reason is not not going to change that until it is too late.
When I was young I did a lot of skying with my friends, and you would never see us on the piste, we would always go off-piste, we knew it was not always the right things to do, but we had the confidence to make that choice and to see it as the right choice.
Nowadays, when many do not see themself “at risk” or to having risky behaviours (check today’s article on Aidsmap), PrEP is the best of the worst.
That’s unfortunate, but so if life, often
As a public health Engineer by adding chlorine to water you prevent the majority getting sick surely if you give prep in a small dose to high risk groups over time you will reverse the spread of the illness eventually like small pox you begin to eradicate this pernicious disease
Ah Alan if it was that easy and simple! But the problem is that for PrEP to work users need to take the right dose (not too little, not too much) on a regular basis and currently it is every day and for as long as they feel they need it.
I have spoken to two PrEP users. Both are active barebackers; they do not believe that they will be dealing with HIV as a result of PrEP and their own prior history. Both recommended it to me, and I am going forward to investigate and obtain the medical exam and regime for going on the preventative medication. I find it liberating and good. LIke women obtainin ght e birth control pill. I dont remember anyone being judged for taking the pill all that often, nor should anyone do that here in the case of PrEP for it works and is doing good in Wisconsin to have it
Actually when the pill came out it faced the same judgemental issues as PrEP. It was a perceived as a license for free sex…. You need to be old enough to remember? 😉
Reblogged this on Brother andc11 Lust Journal of Desire and Lust and commented:
For those of us that BareBack; it only makes sense to be on PrEP.
Thanks for this post! It expresses some of the concerns that I have with the availability of “PrEP on Demand.” Keep up the great writing!! You are insightful and brave!!