Why the hell not?

I’d like to say that my decision to start PREP has been fraught with many sleepless nights, wracking my brain over the pros and cons. What will the impact be on my health? My lifestyle? And most importantly, my sex life?? But the truth is my decision was more of a “why the hell not”.

Let me take you back a bit. About six months I started working for an AIDS Service Organization. While I had a lot of experience working with PHAs, this was my first time in the thick of things with a group servicing exclusively people living with HIV. I've learned a lot. For instance, I had no idea that OHIP did not cover HIV medications. In Ontario, the only way to have HIV meds paid for is through private insurance, or ODSP. Before then I had been working predominantly with street involved drug users, a population who is generally on ODSP or OW to begin with. So it never occurred to me how other people were paying.

The other thing I started learning more about was transmission. I knew a bit more than the average person, but I know now that this isn’t saying much. The most learning I did was around the risks of transmission for people who are poz, but undetectable. I was pretty sure that undetectable folks were less likely to transmit to their partners, but I didn’t understand how much less. That is until I was afforded the opportunity to meet Dr. Mark Tyndall the director of the UBC Center for Disease control. I could go on to list his credentials, but they are extensive. Just trust me that when it comes to HIV, this man is one of the leading experts in Canada. What he explained to me was that no Doctor in the world will tell you there is 0% risk for HIV transmission, even with a partnere who is undetectable. In the same way that no one can guarantee the sun will rise tomorrow.

                                                                    He can be a real dick about it sometimes.

Science doesn’t deal in certainty, it deals in probability. The Sun should rise tomorrow. In all probability it will. But there is still a small percentage of a chance it will not. And so Dr. Tindall will not say words like “cant”, “wont” or “never”. Instead he used the word negligible. The possibility of HIV transmission between a serodiscordant pair, if the viral load is undetectable, is negligible. That was a real eye opener for me.

Having grown up in the late 80’s and 90’s, I came of age during the years when fear of HIV/AIDS was palpable. The nightly news was filled with horror stories about toilet seats, needles in public parks, or sharp objects hidden in seat cushions

                                             Holy. Fucking. Shit. That bitch is trying to kill you! 

Growing up gay in that climate certainly didn't help set my mind at ease. And so i feel that as soon as i became sexually active there was a kind of shadow hanging over everything. Let me be clear, i'm not afraid of sex. I don't let worry get in the way of me enjoying myself, or being open to new experiences. But i would be lying if i said the shadow wasn't there. Especially in the last few years as my relationships have been open ones.

Pictured above: NOT my Grindr pic

And if i'm being perfectly honest with myself (and you too, i guess) for a large part of my adult life i would not have been comfortable having sex or a relationship with someone who is HIV positive. Now i'm ashamed to admit it, but then it would have felt like playing with fire. And that has been MY loss. There a lot of really great people out there who are poz, and i'm sure many of them would be great partners/lovers. I've come a really long way on this point in the last 4 years and my feelings have changed. But yeah, i've got to own that.

And finally i came to the crux of things. Why am i going on PREP? My sex life is very low risk, i'm not an IV drug user, and i don't really plan on changing those things once i get started. But why the hell not? I'm incredibly fortunate that my medical benefits will cover 100% of PREP, and if using safer sex and positive prevention make me even more comfortable in my sex life, what have i got to loose?