|"Color Pills," 1998|
Visual AIDS has asked community members to share their thoughts on the recent FDA decisions, recommending the approval of Truvada as a form of PrEP, and the sale of Oraquick’s rapid, over the counter, take-home HIV tests.
Through these blog posts, we hope to encourage conversation around these current events, and inspire artists, writers, and others to consider what is going on right now in terms of HIV/AIDS. For more information, below are links.
Cyd Nova: I had lunch with Tony to talk about the possibility of him going on PrEP. For twenty-five years he’s been having mostly protected sex, but with a few fuck ups, which sent him into an anxiety spiral. Now he feels in control: making mathematical calculations, picking partners with undetectable viral loads and having conversations about their mutual medication barriers. Now he is experiencing intentional barebacking, instead of it being a slip-up. This is a slip-up both he and I have had: guiding someone’s raw dick into our holes. It’s that moment where you just want it real bad, or need something to give the sex change meaning. Or you just want them to cum more quickly. But then, afterward comes the month of PEPing and calculating window periods. I understand why PrEP would work for him, feels like a right he should have. After all, other than the prohibitive cost, is it so much different from birth control pills? Is the only reason it feels more complicated because we live in a culture that devalues the worth of queer sex?
There are a couple of ways you can think about PrEP: on an individual level, on a public health level, and in questioning its place in the growing divide of what HIV prevention looks like for those who have insurance, versus those without.
Thirty years into the AIDS epidemic, there needs to be prevention strategies other than condoms. I appreciate PrEP being an option. Simultaneously, the increasing biotechnological approach to HIV prevention feels dangerous to me. After AIDS drug availability was something that was fought for so tirelessly, there seems to be little language to criticize the new single-minded, ART-based approach to HIV prevention. With community viral load suppression, “Test and Treat”, and PrEP as the “Brave New World” we are entering I wonder how this will play out on the ground for the people unable or unwilling to access drugs.
PrEP doesn’t make sense as a widespread prevention tool. For many people who are HIV-positive, getting access to and staying “med compliant”, is a struggle, to jump through the hoops of Medicare, ADAP, or even private health insurance. Not to mention how hard it is to take meds when you are struggling with issues of homelessness, trying to hide your status, drug addiction and/or mental health issues. For low-income HIV-negative people PrEP would be further complicated by the cultural shaming and the “we won’t pay for promiscuity” taxpayer mindset.
There are so many questions about PrEP: Exactly what is its efficacy? What are the long- term side effects of taking Truvada? What are the risks of drug resistance for those who do seroconvert? But the biggest question I have is what effect will PrEP have on the rapidly diminishing programming aimed at marginalized communities. My fear is that programs that provide community building, education, and realistic risk reduction will be replaced with pills for those who can negotiate the system, while those who can’t will be, once again, left with nothing.
Cyd Nova is a community organizer and harm reduction ho. He revels in the company of ACT UP provocateurs, dirty queerdos, and a condom eating dog. Excited to explore the limits of TMI, his stories span across frenzied visions of queer apocalypses, the vulnerability of glory holes, and transsexual revisionings of history. He has written many zines of varying qualities, for Pretty Queer and HIVandHepatitis.com, and for upcoming trans anthology The Collection. Website: cydnova.wordpress.com
If you have any questions, comments, or would like to share your own reactions please email us at email@example.com
Read other posts in the series:
All images are from the Frank Moore Archive Project.
FDA and HIV/AIDS http://www.fda.gov/ForConsumers/byAudience/ForPatientAdvocates/HIVandAIDSActivities/default.htm
Truvada as HIV Prevention
Take Home HIV Tests