How PrEP is breaking down the barriers in the gay community

Thanks to PrEP the transmission barrier has essentially been removed, bringing the community closer together.

Health Sexual Health Bill Coleman, PhD

During the HIV/AIDS crisis of the 80’s and 90’s, HIV created a divide in the gay community. Over time, it divided the gay community into three groups: positive (poz), negative (neg), and unknown. Guys developed strong feelings about their individual HIV status, and the status of others. There was a period of ‘us or them’ way of thinking. Concerns mounted over HIV status and transmission. However, with the introduction of pre exposure prophylaxis (PrEP), the risk of transmission is almost completely eliminated, breaking down the barriers within the gay community.

HIV positive guys gained a negative stigma by neg guys, which made them feel embarrassed and ashamed. Neg guys have been fearful of contracting HIV and feel uncomfortable with having sex with poz guys. Thanks to TasP and PrEP, the transmission barrier has essentially been removed, bringing the community closer together.

Taken once daily, Truvada, the brand name of the prescription drug for pre exposure prophylaxis, takes action before an infection can be established. With an estimated $950-1,025 CAD / 30 days, most insurance companies in the United States cover the prescription. For Canadians who do not qualify for insurance coverage, they can access the PrEP for under $100 / month.

How PrEP is breaking down the barriers in the gay community

What does it mean to “stop a person from getting HIV”?

Life does not have guarantees; there are always risks. For example, when you walk into a building there is a risk that there could be an earthquake, a gas leak, a meteor, or a plane crash. When you enter a building you expect to get out alive; but sometimes, in rare and extremely isolated instances, things happen. For almost five years, HIV negative men have been taking PrEP to remain HIV negative, with astounding success; however, there are no guarantees.

There are many jurisdictions where PrEP is completely covered, including Washington state, New York state, and the Province of Quebec. The United Kingdom is still struggling to get PrEP approved. Gildead Sciences, the manufacturer of Truvada, the brand name prescription drug used as PrEP, has petitions submitted in multiple jurisdictions, awaiting authority approval.

How HIV has changed the gay community.

In the 1980’s the gay community was under attack. It became an era where sex equalled death. Today, the HIV negative community doesn’t have to worry about living with the disease. The dating and hook-up scenes are changing. PrEP is once again giving communities sexual freedom, liberation, and sex without fear. Negative guys don’t have to worry about getting HIV; it’s changing the fabric of the gay community.

Poz and neg guys attitudes are changing.

HIV neg guys attitudes are changing. They are more accepting and open. There is less stigma about being HIV poz.

Poz guys are less worried about infecting neg guys. They are facing less stigma. The divide between poz and neg is slowly starting to fade.

The term ‘undetectable’ has become common, opening the door to more relaxed sexual contacts. PrEP takes it to the next level. There is less prejudice and guys are once again beginning to associate with one another, easier. HIV status is starting to become less common between serodiscordant partners.

STI’s are become more prevalent

With HIV becoming less of an issue, the use of condoms dramatically decreases, which could potentially lead to more sexually transmitted infections (STI’s). Not everyone who is undetectable or on PrEP will have condomless sex. Today’s gay men are more educated on STI’s, prevention and treatment, testing, and accepting, than those prior to the HIV/AIDS crisis. Today, guys get tested more frequently, and will continue to increase as the use of condoms decreases and the use of PrEP increases. Frequent testing reduces STI rates.

Neg guys on PrEP

HIV neg guys are more accepting of condomless sex with poz guys. The barriers and stigma of HIV are beginning to shift. People who take PrEP do not see HIV neg or poz partners any differently. This has created better connections and more comfortable environments between serodiscordant partners, better sexual bonding, acceptance, and self-esteem between both the poz and neg communities.

Neg guys are engaging in varied sexual practices because they feel more confident. They are more liberal, free, and experimental in their sexual activities.

How PrEP is breaking down the barriers in the gay community

The older HIV neg community

The gay community has faced a tough number of decades. Guys in their 50’s and 60’s have watched their friends get sick and die. Death has plagued the community with trauma, which has created a community of men who refuse to have anal sex because of the fear of dying. Some of these men are excited, optimistic and embracing of PrEP, to renew their desires to have anal sex, while others remain in fear and anxiety.

The ‘get out of jail free’ card

Some may see PrEP as a ‘get out of jail free’ card. There is a perception that those taking PrEP can have fun without the worry of getting HIV. This makes poz guys feel like they have a life sentence without a chance of parole. It seems unfair. This attitude among poz guys only lasts a short time before they realize the benefits of an HIV neg person protecting themselves against HIV. While there has been some hostility among poz guys, who may have had initial concerns about the unfairness of other guys having a ‘get out of jail free’ card, the hostility lasts only a short time before they embrace the good fortune for neg guys.

Community action movements

For decades the gay community has protested and demonstrated for acceptance and equal rights. It’s been a struggle for the gay community to find common ground to bring them together over the past two decades; however, health has been one of the most important and underlying denominators. Better access to HIV treatment and prevention has helped to bridge the gap.

Governments need to take greater care. Treatments preventing serious diseases, including HIV, need to become a top priority for all levels of government. They can’t just stand by. There are treatments available to reduce the transmission of HIV; it’s called PrEP. It’s brining communities together. More work needs to be done.

Sexual health organizations require funding from government-funded organizations; which worry about criticizing the needs of the community, including medical treatment, education, and prevention, in fear of loosing funding. It will take a grass-roots movement to take on governments to fight for the needs of the community.


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