This is wonderful to hear! I’m transgender, polyamorous, and on PrEP. Often trans people didn’t get to have the sex they really wanted for a long time, and after coming out there is this sense of liberation and joy along with a new found appreciation for sex. I’ve heard it said that “sex is an adult form of play” and that’s how I see it. It’s extremely fun to get together with another consenting adult and explore what feels nice together. PrEP has already been a game changer for our sense of safety and possibility. It’s always reassuring when you meet someone, find mutual interest, and then when discussing safety you find you’re both on PrEP and get regularly tested. I’ve never had this experience before as for a long time I dated in serial monogamy and had one new partner every three or four years. With an expansion of sexual partnership opportunities I’m learning so much about the myriad ways I enjoy relating to others, and finding so much fulfillment in this part of my life. These medications are truly wonderful. We owe so much to those who came before us and lived their truths despite the risks, blazed the trail for people like myself and our community today, and lost their lives or loved ones as a result. We should never forget the fight it took to gain this recognition, or the people who resisted our right to freedom along the way.
I want to say also that I recognize this trial was largely among presumably heterosexual people in an HIV stricken region, but my experience is in the gay and trans community in the USA and I wanted to share a personal story of the value these drugs have had for us. My story will no doubt attract some weird comments, but I hope we all recognize the value of consenting adults making their own choices. We all deserve to find our joy, and I suspect most of us recognize the value of sex and pleasure in some form or another. I hope my story provides some insight in to what drugs like this can mean to communities around the world. Love to all people. <3
Edit: By the way here’s some book recommendations on polyamory. You too can find this joy if you’re in the right community and you develop the skills to handle things with maturity and respect, while identifying others who have done the same work. It’s been a ten year journey for me, but it has been well worth it. Books: “More Than Two, 2nd edition” (2nd edition is in preprint but recommended over the first) “Polysecure”, “Polywise”. Good luck exploring! Oh and finding a supporting therapist made all the difference for me in this journey too. That one is harder but see the directory on the Psychology Today website and take advantage of their filters.
Thank you for sharing. I know hostility toward the queer community still exists and admire your ability to dismiss the hatred as “weird comments.” It takes a steely resolve to develop that kind of resilience.
As an older straight male, I grew up when it was still commonplace to be openly hateful toward your community and it’s taken decades for me to unlearn that hatred I learned as a child, but the effort has been worth it, so I thank you for your effort to educate me, as I still have a lot to learn from your community.
Well I hope this isn't a weird comment: thanks for expressing your views so clearly and positively. It opened my eyes to an aspect of genuine and human exploration of newfound freedom and caring.
Thank you! I’m so happy it was enlightening. It’s a space we don’t often discuss and I think these stories need to be told. We all deserve the sense of joy that can be found in the exploration of our bodies and others.
HIV is just one of many STDs - are you not worried about all the others too? We have a resurgence of gonorrhoea and syphilis in developed countries. If the answer is “just get tested first”, then why wasn’t that the answer for HIV too?
Without trying to be judgmental, describing STIs as a mere inconvenience seems incredibly cavalier, eliding a whole world of bad outcomes. Antibiotic-resistant gonorrhoea is on the rise, which is only going to get worse if we adopt a “just throw antibiotics at it” attitude. There’s a long horrible list of diseases that might not have the notoriety and lethality of HIV, but are still life-changing. Genital warts have no guaranteed cure. Herpes is treatable but not curable. Syphilis can cause adverse birth outcomes so even if it doesn’t affect you, spreading it can affect others. HPV is widespread but is associated with cervical cancer deaths, so not something we want more of. Then there’s monkeypox, hepatitis B, scabies, lice…
“Do as thou wilt, consenting adult” is one thing, but superspreader behavior affects the whole world through the network of relationships we all have with each other.
Right, herpes happens and it’s possible I may contract it some day and I and my partners are okay with that. People in the community vary on how much they care about this, but everyone I know that has it isn’t particularly bothered by it. Nothing like HIV. I still talk with people about herpes and make an informed decision about whether and how to engage with that person sexually. Someone may not know they have it and might be infections and that’s a known risk.
For gonorrhea, that’s what the clear conversation about testing status and other partners is about. I ask the person about everyone they have been with since a few weeks before they got tested, and what protection they used and the testing status of that person. Usually it’s only a few people because I don’t do the super promiscuous hookups some people do and I won’t have sex with someone who does. If worst case they contracted gonorrhea in between their recent test and the time we play and I contract it from oral sex with them, then my next plan would be antibiotics. If that fails and it’s antibiotic resistant, then that’s the risk I take. But you can see there are multiple steps along the way to reduce that risk.
Monkeypox doesn’t require sex to transmit. If I’m making out with someone or cuddling that’s still a risk, and I cuddle with a lot of people. I should probably get the vaccine. Lice also don’t have anything to do with sex. There’s a lot of ways you can be in close enough contact with other people who have lice. But seriously I haven’t seen that one since I was a child. Not even on my radar.
I have the HPV vaccine. Genital warts are caused by HPV so that’s probably low risk for me.
Syphilis is another one that comes with regular testing, so the risks are a similar story to gonorrhea.
I am vaccinated against Hepatitis B.
All of this stuff is calculated risk. Sex is extremely fulfilling for me, and every person likes to have sex differently. I did monogamy for 20 years. I had some great sex but I never experienced the joy and variety of sex that I have until recently. Living as a human being involves some risk. If you go hiking in the wilderness you could get killed by a bear. But people take steps.
And “just throw antibiotics at it” is a mischaracterization of my approach. I go through regular rigorous testing, I have clear direct communication with others about their testing status and sexual history, I only do oral without barriers but do use barriers for penetration, and most of the people I’m sleeping with are people I’ve known for a while or other people close to me know.
There’s no superspreader behavior. There is careful effort to reduce risk significantly and an awareness and acceptance of the risks as they exist.
In my world, sex without a condom with people you do not know and trust is asinine.
And as I understand it from my interaction with gay people, it is not that they take PrEP to reduce the non zero chances of contracting HIV while having protected sex, but it is to be able to have unprotected sex while completely disregarding other STIs.
It makes a big difference for oral sex. In queer communities "sex" means a lot of things. My agreement with my partner is that if I am going to have sex with someone else, first we have a conversation about testing status and sex partners, and if that goes well we can have oral sex without protection or have penetrative sex with condoms.
I don't really have sex with people I don't have some level of trust with, but we are all sleeping around a bit and even someone you trust can make mistakes. Most STIs are curable or not a big deal, but HIV changes your entire life. With PrEP, you allow yourself some freedom to take a calculated risk. I mostly don't have sex with someone unless they are on PrEP too, because I only have sex with responsible mature people and in our community, taking PrEP is the responsible and mature thing to do. But we are still fooling around with a lot of people. If I am on PrEP and the person I am hooking up with is on PrEP, the chances of getting a life changing STI become extremely low.
There is another factor. With my doctor's office, which sees a lot of people in the community, they won't let you be on PrEP unless you get tested every three months. So in many cases if someone is on PrEP they are also getting regular testing done. That is not a direct result of PrEP, just an administrative side effect, but what it means is that if I go to a sex party and someone wants to go down on me, as happened in January, then if we are both on PrEP and getting tested every three months, then that interaction is very safe. When I did this it was with someone my girlfriend (who was also at the party with me) knew before I did, so there was some level of community trust there.
I think this is a misunderstanding. People are already having a whole lot of promiscuous unprotected sex. The function of PrEP is to make that sex safer.
My friend used to volunteer at an LGBTQ support shelter. She knew gay men who had promiscuous unprotected sex 20 years ago. Some of these people had been so marginalized by society and abandoned by their families that the connection from their random sexual encounters was the only thing they had. She knew a guy that was willing to do it no matter the risks. One day he found he had contracted HIV, and not long after he committed suicide.
I’ve been to sex parties before I was on PrEP, and the arrangement is the same. Have a conversation about testing, and if everything sounds good have unprotected oral or use condoms for penetration.
The difference is that now with PrEP this feels much safer as one of the most significant STIs is no longer nearly as easily transmitted.
> Some of these people had been so marginalized by society and abandoned by their families that the connection from their random sexual encounters was the only thing they had.
See I don't really buy that. Because I have seen what the gay community in Berlin is like. Nobody is marginalised any more, it is more than accepted. It is even celebrated.
And they still have two hookups in a random toilet or in sleazy saunas before lunch.
And of course not all gay men are like that. But male sexuality tends to be more uninhibited. Why don't female lesbians display this behaviour ?
I am against the prevailing hedonistic culture. A culture that promotes eudemonia instead, is in my opinion greatly beneficial to both the individual and the society.
> See I don't really buy that.
This was a story about the gay community in South Florida in 2005. If you know anything about Florida, you can understand the statement that "some gay men are marginalized" is easily believable. Now today things are better, but a lot of my friends have come to Oakland fleeing dangerous places where their families kicked them out for being gay. You're talking about the scene in Berlin, but consider the scene in Oklahoma or... Florida today. Its still bad there.
> Why don't female lesbians display this behaviour?
Try undergoing a transition from a testosterone dominant system to an estrogen dominant system and you will understand. The nature of sexual urges under testosterone is very different from that of estrogen. Arousal under testosterone feels very urgent. I can control myself but imagine an abused 20 year old who never learned healthy self management. Without PrEP their urges may get them killed before they ever learn to control their impulses.
> I am against the prevailing hedonistic culture.
You can be against whatever you want. I am just explaining some facts about the benefits of PrEP for people that think differently from you.
> Try undergoing a transition from a testosterone dominant system to an estrogen dominant system and you will understand
Exactly my point. Ephemeral promiscuous sexual relationships are not due to marginalisation, but inability of what seems to be the majority of gay men to manage their sexual impulses. PrEP facilitates that, and aids in the spread of all other diseases, as in the absence of HIV the protection levels people opt for are super low.
You were the one saying that you take PrEP to feel more comfortable having sex with people you do not know so well, or in sex parties.
Your argument that gay people are so marginalised that ephemeral sexual encounters are the only form of community or socialisation they have simply does not hold with a very cursory interaction with the gay community, whether that be in person or online.
You are right in the sense that there is groups among the MSM community who feel emboldened by PrEP to have unprotected promiscuous sex. I've ran across this mindset myself. It's a free world but the mindset is short sighted: there is many other diseases who spread more freely thanks to the carelessness instilled by PrEP.
I agree that PrEP should mainly be seen as a means of derisking the worst case scenario of what happens when a condom breaks, falls off, etc. It's an amazing gift in the fight against HIV, but only for HIV, not the other diseases.
I wouldn't say this mindset is present in all gay people though, one should differentiate. Many gay people I talk to are very aware of the distinction.
> It interferes with the HIV capsid, a protein shell that protects HIV’s genetic material and enzymes needed for replication.
Do I understand correctly that this means an individual HIV virus cannot replicate in the presence of the drug? I assume there must be more to it because otherwise this would be a cure?
Effectively HIV stops replication in a presence of the drug, similarly to HIV drug regimes used today. However HIV is a very nasty virus - it’s called retrovirus because it writes itself into cell’s DNA (nucleus/core). So while those cells are alive as soon as you stop taking medications you will have virus resurgance. Some of those cells are in bone marrow and permanent. Hence stopping the replication of HIV isn’t enough for cure.
Hoping an expert will chime in but my lay understanding is that one difficult part of treating HIV positive patients is the ability of the virus to hide in areas that are exceptionally difficult to reach. In addition, HIV has a robust ability to reinfect a host from a point of undetectability hence the needs for lifelong treatments.
Some of the drugs are intramuscular injections of formulations that take months to metabolize. As they metabolize, the active ingredients enter the bloodstream.
We can see that already with existing PrEP formulations: in the US, the drugs retail for several thousand dollars for a single month's supply, and insurance companies had to be strong-armed into even covering them.
You keep commenting here about how HIV is the fault of the people who have it. Now you seem to be arguing that if there are people who have HIV and it's not their fault, they don't matter because they're statistically unlikely. That doesn't track.
There are many thousands of people that have HIV through no fault of their own. And there's no reason that this drug is not a good idea for those people.
Two days ago: Over 2,400 patients may have been exposed to HIV, hepatitis infections at Oregon hospitals
Whose fault?
> The Oregon Health Authority said that investigations into the breach centered around a physician who delivered intravenous anesthesia and employed "unacceptable infection control practices, which put patients at risk of infections."
Can you read? "Protection, not cure". Are you going to make everyone take it ad vitam aeternam just in case of potential medical errors?
A cure to HIV would be welcome in theory, though I'm sure it'd be distributed like candy to people who don't want to be responsible for their questionable choices.
its amazing how cynical (all) people are by nature - I'm 49, and I remember when HIV was a horrible scourge, we forget, so quickly, how things were, and our advances seem trivial. -assuming this news is true or accurate, this is a remarkable advancement for humanity.
I want to say also that I recognize this trial was largely among presumably heterosexual people in an HIV stricken region, but my experience is in the gay and trans community in the USA and I wanted to share a personal story of the value these drugs have had for us. My story will no doubt attract some weird comments, but I hope we all recognize the value of consenting adults making their own choices. We all deserve to find our joy, and I suspect most of us recognize the value of sex and pleasure in some form or another. I hope my story provides some insight in to what drugs like this can mean to communities around the world. Love to all people. <3
Edit: By the way here’s some book recommendations on polyamory. You too can find this joy if you’re in the right community and you develop the skills to handle things with maturity and respect, while identifying others who have done the same work. It’s been a ten year journey for me, but it has been well worth it. Books: “More Than Two, 2nd edition” (2nd edition is in preprint but recommended over the first) “Polysecure”, “Polywise”. Good luck exploring! Oh and finding a supporting therapist made all the difference for me in this journey too. That one is harder but see the directory on the Psychology Today website and take advantage of their filters.