NHS England announced this afternoon that it is maintaining the stance that it has no legal power to commission PrEP. As you would expect outrage from HIV organisations and activists followed but so too did the inevitable slut shaming that has shadowed the PrEP debate from the outset.
Central to anti-PrEP slurs and comments is condom usage. And the fact that simply because they exist everyone must be able to use them – and should be using them all the time. We’ve been led to believe this thanks to the appalling state of sex education in the UK, and also in part to the devastation that the HIV outbreak caused before the advancement of effective antiretroviral treatment in the mid-late 90s. It’s been the only consistent ‘safe’[r] sex message for the best part of the past thirty years.
For the majority of men sex education will have included instructions on how to ‘make’ a baby, immediately followed by instructions on how to avoid this. And in these explanations the only contraceptive that a man (especially a gay man) can relate to is a condom. They are king, the bee’s knees, and the crème de la crème. They solve everything, they offer full protection and they’re suitable for everyone. But this isn’t the case – we’ve just been heteronormatively conditioned to believe so.
Condoms are extremely effective at stopping the transmission of a variety of STIs, including HIV – but there are plenty of transferrable infections that condoms offer little or no protection against. Close skin to skin contact is enough to transmit herpes for a start. And who is actually using condoms when taking part in oral sex, and whilst we’re talking about oral sex how many of the guys shaming people wanting PrEP use a dental dam when rimming or being rimmed? There are plenty of infections passed to and from the mouth and throat, and just because they are passed orally doesn’t mean they are any less dangerous, antibiotic resistant gonorrhoea being one such example.
Condomless sex happens for a variety of reasons; pleasure, psychological issues, peer pressure, sexual abuse, confidence… the list goes on. So some guys just believe it feels good, so what, that doesn’t mean they don’t deserve to be provided with a form of protection against a life changing condition like HIV.
Our straight peers have enjoyed the benefits of a variety of contraceptives for decades now to stop unwanted pregnancy; condoms, the coil, the contraceptive pill, the morning after pill – and injections and implants. They’ve managed to make room for alternatives, for different life choices and to suit different lifestyles. It’s time gay men realised that there is another way to prevent HIV, condoms don’t need to take up all the room on the shelf – there is an alternative and it works.