I have gay sex with gay men. Not as much as I would like, mind you, but I’m striving. I am also single and new to Los Angeles — six weeks on the job, three parking tickets, two earthquakes, and one fender bender. So I’m official. This week I get my first prescription for the PrEP (pre-exposure prophylaxis) drug Truvada, which has proven to be effective at preventing HIV infection. I am an HIV-negative gay Latino — part of a group at higher risk of infection — who is quite capable of making my own decisions about my health care. I do not want Truvada in place of condoms; I want Truvada in addition to my condom use.
Some critics say Truvada is a “party pill,” outrageously equating it with recreational drugs, and that those who use it will have more unsafe sex and higher rates of HIV. To be sure, some gay men will use Truvada without condoms. Some gay men will choose not to wear condoms nor take Truvada at all. Being on an effective PrEP regimen is a good thing, and Truvada is another tool in the toolbox to protect yourself from HIV.
So I’m going to take it.
Like all drugs, it may have side effects, and as with any other prescription drug, you should consult your doctor. My doctor told me that a rare but possible side effect was that Truvada could harm my kidneys, so we would have to monitor that. I told him that given my love of wine, beer, and the not-so-occasional dirty blue cheese stuffed olive martini, I thought that would be wise.
While the analogy is by no means exact, the recent pushback against PrEP and Truvada reminds me of the sexist old arguments that birth control pills will lead to female promiscuity and forgetting to take a pill can lead to unwanted pregnancy. And, to be sure, forgetting to take Truvada could lead to possible HIV infection. Still, does that mean we do away with birth control and PrEP pills all together? As we say in Spanish, “um … no.”
I am taking Truvada because I have sex with men. I will not be shamed for saying or doing so. I am a young, healthy, professional gay man who goes to the gym every morning, not because I want to look good for my trainer (not entirely, anyway), but because I want to stay healthy. And Truvada will help me.
HIV and AIDS remain a serious problem for our community, especially for men who have sex with men and our transgender brothers and sisters. We know we can end the epidemic if we can get people tested and keep them in care. Access to Truvada is about providing options. We have a responsibility to provide access to as many tools possible that have been shown to help protect against HIV.
If I want to take Truvada and use condoms to protect myself against HIV, I will. If an HIV-negative person is dating an HIV-positive person (a serodiscordant couple), it makes sense that they have the choice to be on Truvada. If a person chooses not to wear condoms, it makes sense that they have the choice to be on Truvada. If you’re new to L.A. and you’re looking to meet the love of your life named Seth who looks remarkably like Josh Hartnett and are sexually active, it makes sense to be on Truvada.
It’s my body, it’s my life, it’s my choice, and no amount of sex shaming or dissemination of misinformation will change that. I will make my own educated decisions based on the research and evidence regarding PrEP and Truvada, and I strongly encourage you to do the same.
Seth, I hope you’re reading.
ANTONIO DAVID GARCIA is the director of policy and community building for the L.A. Gay and Lesbian Center.