Last week, posters began plastering the streets of Melbourne’s CBD bearing the brash message that gay men can “fuck raw” using PrEP.
The posters – which a group of activists claimed responsibility for – were certainly intended to court controversy and they accomplished that, sparking a polarising debate within the gay community about fear, stigma, promiscuity, risk and responsibility.
Truvada, as the drug is known commercially, has been dubbed the gay man’s contraceptive pill against HIV. The drug has been proven to up to 97% effective at preventing HIV if taken daily, which makes it almost as reliable as condoms. In San Francisco, and US cities where the drug is legal, HIV transmission rates have dropped dramatically.
The trouble with Truvada is that it isn’t available in Australia, because the drug is not yet approved by our Therapeutic Goods Administration. Moreover, PrEP isn’t yet on the Pharmaceutical Benefits Scheme so it isn’t subsidised.
While there are trials currently underway, there are no places left in the trials. As a consequence, gay men in Melbourne who getting prescriptions and buying the drug online from the US.
Many in the gay community – and even more so the straight community – wring their hands and condemn anyone who has unprotected sex as irresponsible and selfish, this moral judgement and shaming doesn’t stop HIV transmission. In fact, it makes it worse because many gay men won’t get tested because they are afraid of knowing the result, and these wilfully blind people are actually the most at risk and the most dangerous.
Whether we like it or not, there will always be people who have unsafe sex, and there will be times when even contentious people do something reckless. That momentary lapse in judgement shouldn’t be the end of the word.
PrEP doesn’t of course prevent other nasty STIs – from herpes to gonorrhea – so you should still always wear a condom, especially when fucking someone you’ve just met.
PrEP also might not always be effective in preventing HIV, as the virus might become resistant. And no one knows yet what kind of long term impact it might have on an otherwise healthy person.
Slogans are a crude ways to express a nuanced message. Having subsided access to PrEP isn’t about encouraging gay men to have unprotected sex. For gay men who have grown up after the AIDS epidemic, fear is often the dominant emotion they associate with sex, and PrEP removes that fear. More importantly, it allows gay men to contemplate relationships with HIV positive partners when they might not have before.
Further afield, on the topic of HIV medication, this week the LGBT community found a new nemesis when the New York Times reported that a 32-year-old hedge fund brat Martin Shkreli had bought the rights to a 62-year-old AIDS medication called Daraprim jacked up the price from US$13.50 a tablet to US$700. It turned out Martin hadn’t thought this money making scheme through too well. Everyone – even Hillary Clinton leapt to condemn the price-gourging arsehole, but the pharma CEO initially defended the 5,000% price hike on the basis that it was necessary to make the drug used to treat toxoplasmosis in AIDS patients financially viable. By the end of the week, hackers had doxed him releasing his home address and phone number, and suddenly Martin was ready to backflip.
While he hasn’t disclosed what the new price for Daraprim will be, there’s already a special place in hell reserved for him regardless.
