Actually, he’s wrong. It is.
* * *
I began to think about Truvada last fall, when a friend of mine mentioned that it was gaining currency as an HIV-prevention drug. This friend knew that I generally only had condomless sex—and that as a result, I rarely had sex at all. As a gay man who has receptive sex—and who lives in Miami and Washington, D.C., the cities with the first- and fifth-highest HIV rates in the U.S.—I knew how high my risk was, and for the most part, I wasn’t willing to chance it.
I already had eluded HIV once before. In 2013, during a vacation in Chile, I’d hooked up with a guy I met at a club. We maintained a long-distance relationship, and when I went to visit him in 2014, I came with two over-the-counter HIV tests. He tested positive. At a seaside resort where we traveled to soften the blow, he developed a crippling fever, and we were forced to seek help from an urgent-care clinic. Tengo SIDA, he told the nurse. I have AIDS. What I remember most was the taxi ride from our hotel to the clinic where he clung to me, bawling, as he repeated that he didn’t want to die. To him, AIDS was a death sentence. Everyone he’d known with HIV had died.
Usually, when I mention this, I omit that I didn’t actually buy the tests. In fact, this same friend of mine, the one who would later tell me about Truvada, handed them to me to tuck into my suitcase before I left. The takeaway: I dodged infection because someone who loved me knew that encouraging me to use condoms would fail.
So when another Miami friend of mine mentioned he was taking PrEP, I began to consider it. I made an appointment at my doctor’s office. The physician’s assistant listened attentively as I explained my situation: gay man, age 33, inconsistent condom use, high-risk behavior. I said: I’m interested in starting PrEP.
He told me he wouldn’t write me a prescription. It’s for couples where one partner is HIV-positive and the other negative, he said.
He suggested I use condoms, adding that straight men manage, and they have to worry about pregnancy, too.
Tape a condom to your leg, he told me.
Flabbergasted, I made an appointment to see another doctor, one whose name I’d gotten from a friend already on PrEP.
How often do you have sex without a condom? this new doctor asked.
I explained my situation: I was there because I don’t like sex with condoms. I knew it put me at risk, so I rarely had sex. I knew it wasn’t the right reason to ask for PrEP, and I knew it wasn’t 100-percent effective, but I knew asking for it was the right thing to do.
Hmm, he murmured. If he had an emotional reaction, it didn’t show.
Then he said what every gay man seeking PrEP should be told: Well, it’s great that you’re trying to protect yourself. You’re doing the right thing.
He ordered the necessary blood work and told me to come back in a week.