The PrEP Diaries: A safe(r) sex memoir
The following is an excerpt from my new book, The PrEP Diaries: A Safe(r) Sex Memoir, now available from Lethe Press. The book chronicles the before-and-after of using Truvada PrEP, a recent breakthrough in HIV prevention that has prompted a new sexual revolution--except that most individuals have no idea it exists. Through sex positivity, explicit openness, and fun, I hope to make many more people aware that PrEP is an option for them in not just preventing HIV but having a better, braver sex life.
I was very lucky to grow up with little shame in my household; the fact that my parents are former flower children probably has a lot to do with that. I was never taught to be ashamed of being a sexual human. They never told me that being gay was bad. Promiscuity itself was rarely judged, though I was taught that I should care about the people with whom I have sex. I wasn’t taught that masturbation was wrong. It was just a thing people do. It wasn’t outright encouraged, but it was just a human thing.
When I was about twelve or thirteen, my sister gave me the masturbation talk one night, much to my surprise. I don’t think my parents put her up to it. I’m sure my dad would’ve figured out how to bring it up if it were an issue. She was already out of the house and on her own; she’s ten years older than me. Maybe she was visiting for a holiday or something. She was fixing her hair and makeup in the bathroom. I kept her company. We became closer and closer throughout my teens, especially as my parents had rough times in their marriage. My sister was always there to rescue me.
She casually rolled a strip of blond hair around her curling iron.“Have you started masturbating yet?”
The honest answer was Yes, every day! Sometimes two or three times! but what I said in my gobstopped shock was, “No! No. Uh-uh.”
“It’s fine if you do. It’s normal. Just keep it to yourself.” She applied some eyeliner. The dexterity needed to operate a curling iron while applying eye makeup is beyond me. I can’t even play drums.
I’m not sure why she brought masturbation up and then suggested I keep it to myself. Had I been talking about it? Maybe I’d been overheard talking to friends. Maybe I’d left evidence. Who knows. I’d probably left a lot of evidence.
But that’s about the extent of shame in my house: “Keep it to yourself.” I was never given the impression I was a bad person for anything I did. This context is essential for readers to understand my feelings about queer sex and and gender. All of these were considered okay in my family. My parents didn’t want me to be gay or genderqueer, but they’re very supportive. My sister loves it, and she tells me I’m the best parts of having a brother and a sister. She has another brother from her dad (we have different fathers), but she never got to have a sister. She likes to put side-by-side pics of her other brother and me on Facebook, the linebacker mowing the lawn with his shirt off, me luxuriating in a fur coat. Not that I’m against mowing the lawn with my shirt off, mind you. Totes masc, bro.
I’m grateful for my loving, supportive family. I bring this up because I got through life with much less internalized homophobia than a lot of queer people have. That’s important for the following conversation. I’m in no way a fluke, but the shame around sex and being queer is a powerful block to things like self care, which includes PrEP and other forms of prevention.
The internalized homophobia is still there, mind you; I question my gender presentation on most days. Do I look too faggy? Should I act more masculine in a certain situation? Will I be a target for violence? Should I decide to do a butch look for a certain party rather than a femme or genderfuck look? I pray to Saint David Bowie, and he tells me to be strong and do it 100%, no half-steppin’.
There is still a huge amount of shame among queer people. It’s picked up everywhere, from the family home to the church to the social climate of school and the street. I learned most of my self-doubt and homophobia at school, since we had gays in the family and my folks never once took me to a church or synagogue.
I encounter plenty of guys online and in person who have no qualms about PrEP, but I’ve also meet a lot of guys who refuse to take it. This is a separate group from the guys who come across as calm and confident that PrEP isn’t right for them after giving it some practical thought. That group is growing, or so I’ve observed. However, the men who absolutely refuse to take PrEP are a separate cohort.
Of these guys, about a third tell me that they’re against taking pharmaceuticals in general. They don’t trust Big Pharma, or they’re into naturopathic alternatives, or they just don’t like taking any drug they don’t absolutely need. I sympathize with this group. I went through the same qualms in deciding whether to get on PrEP.
The other two-thirds of the PrEP dissidents have offered many different excuses: “I don’t participate in risky behavior very often.” “PrEP is for guys who just want to bareback and have lots of partners.” “I’m afraid of how it might change my behavior.” “No one needs PrEP! Why don’t people just use a condom every time?”
Behind every one of these statements is the same basic sentiment: I don’t want to feel ashamed of myself or my actions. Put another way: I’m afraid PrEP will make me a dirty slut, and then I’ll judge myself.
Heaven help us. I hear all sorts of dressed-up excuses, and again and again they all come back to the same thing. People are afraid that PrEP will somehow convince them they’re invincible, and that being invincible means they’ll end up in the park late at night with their pants down, touching their toes, with a sign taped to their ass that says, “Please fuck me like the nasty little piggy that I am.” Not that they’d ever do that without PrEP. Surely not.
The real underlying fear here isn’t that they’ll become promiscuous. The actual fear is of the shame they’ll experience if they become promiscuous.
HIV has only made the shame situation worse. Gay people don’t merely deal with shame over being attracted to the same sex. Gay men are not just ashamed of actually having sex with another man. We also get ashamed that we did something risky to our health. Thanks a lot, AIDS crisis.
The shame is compounded—the desire, the activity, and the perceived lack of health precaution, all layering to become a McShamewich of neuroses. Plus that extra layer about not being masculine enough. You wonder why gay guys can be so neurotic? It’s because for over thirty years we were told that our sexual orientation is so effectively destructive that it will not only send us to Hell, it’ll be the very thing that kills us.
See another example: on the apps, particularly on Scruff, a lot of guys use the term “clean” when they mean they’ve tested negative for all STIs. “Clean”— the opposite of dirty, marked, or unsanitary. The implications are clear.
The backlash against the term “clean” has also been palpable. There was a meme for a while of guys taking their profile pic in the shower, a social campaign to recognize that “clean” doesn’t mean “disease free” just as “dirty” doesn’t mean “diseased.” It sure is easy to judge sexual behavior when there’s a deadly disease being spread by sex—except that HIV isn’t deadly anymore if you have access to proper care.
That’s actually part of the threat that PrEP represents: people are so attached to their shame around unprotected or promiscuous sex, and PrEP means they’ll have to find a new excuse to judge themselves and others for any mildly risky behavior. Oops! I gave you head on the first date, and I accidentally bit my lip this morning—I hope you don’t give me AIDS. Now I hate myself. Don’t look at me ever again. Get out.
I know that I cling to the things that scare me and hurt me sometimes; clinging to them is familiar. It’s easier to sit idle and be afraid that I’ll never make it as an author, rather than to actually write a book. It’s easier to be afraid of HIV than to learn how it actually works, how to prevent it, and all the many options available. I see other gay men clinging to the fear of HIV and shame around sex, and rejecting PrEP is a way of holding onto those fears and shames rather than resolving them.
Taking Truvada is the exact opposite of sexual recklessness. Taking Truvada daily is precisely an act of sexual responsibility, whether you combine it with condoms or not.
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