When I have anal sex, I’m always a top, and I usually use condoms, even after being on Truvada (tenofovir/FTC) for two years. There are several reasons for this, but HIV isn’t one. PrEP (pre-exposure prophylaxis) and, just as important, treatment as prevention (TasP) and the undetectable status have freed me from concerns about contracting HIV.
Some people think my sexual history makes me a poor authority to talk about sex, HIV and PrEP, even though I’m a gay man who’s had many sexual partners. Others say I’m the poster kid for the HIV generation, someone programmed by our culture to be vigilant against sexually transmitted infection (STI) transmission, to worship the condom as a little latex saint that will protect me from everything if I just believe hard enough and act right, as though condoms are almost equivalent to abstinence.
My last PrEP article for TheBody.com focused on the straight world’s obliviousness to PrEP’s very existence. Now, I can focus on how PrEP is used, not on whether it’s used or even known about.
I decided to write this article after a conversation with my friend Josh. Josh and I hooked up once after I’d gotten on Truvada, and he started on PrEP shortly afterward. The sex was hot, “intimate” in his words, and I’m always happy to hear that. When he asked me over to hook up again, he said he didn’t want to use condoms. I told him that I’m still using them. I was surprised that he then turned me down after bringing up sex in the first place.
I’ve interviewed scores of people on PrEP, mostly cis gay men, and the majority either never use condoms or only use them at a partner’s request. I’ve been thinking lately that I’m in the minority of PrEP users as far as my use of condoms.