I'm sitting in my apartment in Midtown, one of Atlanta's gayborhoods, fuming over an op-ed probably written a mere six blocks away from my home. I'm angry about how out of touch the author is with the community he lives in, and many of the people in charge are in the same boat. AIDS service organizations in the South are still largely following guidelines set up decades ago, when the world was very different. Fighting HIV was like battling a raging wildfire. At my young age of 26 I did not experience the terror of constantly fearing a diagnosis equivalent to a death-sentence, or attending funerals every weekend. I feel a great deal of respect and reverence to our brothers who were lost and to those who held their hands while they faded away.
Many would say that today we are winning the battle against HIV/AIDS. New preventative methods like daily PrEP are protecting many high-risk individuals from a lifetime of suppressing HIV. We are on the verge of a vaccine and possibly even a cure someday soon. The reality is that we're experiencing a resurgence in new HIV infections amongst 18-24 year olds. You can read recent findings from the CDC here. These numbers are staggering and completely unacceptable. The city and region that the author and I both live in is THE hotbed of HIV in America. He himself observes that "the results are so close to 100 percent prevention that some have taken to calling Truvada the closest thing to an AIDS vaccine that we've ever had."
Yet, Alvear fails to realize that his writing holds a huge swath of influence over many young, immature and unknowledgeable men who may be newly out of the closet, exploring sexuality and looking for answers. I was once one of those young men. He projected his personal neurosis onto a world of impressionable gay youth. A lack of formal gay sex health education has left behind a large population of people who are reckless and misinformed. We know they're making poor decisions because condom usage rates are dropping and HIV infection rates are skyrocketing. Relishing in the fact that condoms work for you in a time when it is no longer the only option is not helping anyone half your age.
A friend once told me:
Someone needs to clear out this crowd of 40+ year old 'leaders' who are stuck in the politics and psychology of the 1980s. Almost all of them need to be replaced by younger people who are in touch with today's realities. These old guys are fat and happy; they have settled into a routine . . . and they are as resistant to change as any other type of conservative.
(Mind you, he's 51.) Many local organizations don't believe that new preventative efforts are worth supporting, though the numbers are proving that antiquated methods of care are failing our youth. We also know that PrEP does work. In the last three years, San Francisco has observed a 30 percent drop in new HIV infections since the FDA approved using Truvada as PrEP. At this rate, they could wipe out new infections within a decade. New York Governor Andrew Cuomo's plan is similar: to dramatically reduce seroconversions by 2020 through ramping up testing and preventative efforts like PrEP. None of these efforts will work if there are only people out there publishing false horror stories of terrible side effects and possible long-term consequences.
If you think PrEP is something that you need to be proactive with your sexual health, I urge you to disregard the naysayers. Seek advice from certified medical professionals licensed to advise you on the risks and advantages of Truvada. Join the 8300+ members of the PrEP Facts: Rethinking HIV Prevention and Sex group and read first-hand experiences from serodiscordant gay couples who now no longer worry about being physically intimate, or from heterosexual couples who used PrEP to successfully have babies of their own without infecting their partners. Learn of the liberation that thousands of people are experiencing by taking one pill a day for as long as they feel it is necessary.
PrEP is not a lifelong decision. It is a choice that everyone should make based on sound scientific facts and can be updated as circumstances change. Here's what's not temporary: HIV. I guarantee you that the effects of HIV treatment drugs on your liver, kidneys, etc. far outweigh the possibility of what Truvada alone could do to you. PrEP patients get tested every 3 months for HIV, all other STIs and to make sure that our organs are still functioning properly. Truvada has been used for over a decade to care for HIV-positive people before its use as PrEP, and it is very mild compared to the dozens of other drug cocktails. Don't believe me? Look it up. Challenge the things I write as well as the things that people like Michael Alvear write. Don't let any one person make this huge decision for you. You owe it to yourself to know the truth and choose accordingly, instead of being shackled by a lifelong fear of HIV.
14 months ago when I shared a photo of my first Truvada tablet in my hand just before taking it, I had friends message privately that they're on PrEP too. I was shocked. As I became more vocal about PrEP, I had another handful of friends tell me they wish they had known about PrEP a few years ago, before seroconverting. They congratulated me for being an advocate and wished that others would do the same. This is why I frequently encourage my friends to talk to their doctors about it. As long as there are still ignorant opinion pieces spewing nonsense about not putting chemicals into your body and only eating organic foods as a means to justify a personal decision against PrEP (which in turn affects others' decisions to start or not), myself and others will continue fighting back with facts and first-hand experiences of what it's really like.
We owe it to our community's youth to give them the information they need to know. Otherwise, we're just letting them seroconvert. I hope that thought weighs on your conscience when you worry about whether or not you should come out of the PrEP-closet. The same way that everyone coming out as LGBTQ helps break down fear and stigma, we need to do the same against this bullshit PrEP stigma. Being on Truvada doesn't make you a slut or a whore. It makes you educated, proactive and self-aware. There's no reason to be ashamed of that.