I’ve been living with diagnosed HIV for 18 years. This is hardly a revelation as I’ve been blathering on about it in public forums for the last five years or so.
I don’t know exactly how I picked up the virus. I spent the best part of three years with a man who I knew to be HIV-positive. At that time there were no effective treatments for HIV. We always used condoms when we fucked, but not for oral sex. As far as I’m aware, no condoms ever broke but, you know, it was almost three years, I couldn’t deny the possibility. He would have had a high viral load and so the risk of infection from any exposure would also have been high.
When I was with him we made a commitment to each other. You know, one of those, ‘till death us do part’ ones, even though at the time it had no legal basis. I fully expected to become a young widower. Maybe it was in part the shock of adjusting to a new reality that made it hurt so much when he left me because he wanted to be with someone else.
In the following months I did not play as carefully as I had done. Truth to tell, I was not in a good place emotionally. I was never the bug-chaser of myth but, at the time, I was not particularly motivated to look after my health. I was so unhappy that the prospect of a long life was not particularly inviting. Most of the time I used condoms, some of the time I did not.
I could have acquired HIV as a good gay boy, who always used condoms and who wasn’t afraid to love someone who had an incurable and, at the time, untreatable infection. Or I might have acquired HIV as one of those irresponsible gays, risking illness rather than insisting on condoms. I don’t know if I’ve got good AIDS or bad AIDS.
Of course, the whole notion of good and bad AIDS is nonsense. Nobody deserves this virus. I was the same person in both those situations: flawed, certainly, foolish, most probably, but also loving, caring, a hard worker, a loyal friend, a good son and brother. Everyone makes mistakes. We do so whether or not we are punished for them.
In either scenario, if PrEP had been around then, I would have taken it. PrEP would have negated the risk of infection from the man that I then loved. PrEP could have protected me when I did not have the will to protect myself. If PrEP had been around during those years, twenty years ago now, I probably would not be living with HIV now.
And chances are, if PrEP had been around to prevent me from becoming HIV positive all those years ago, I would have no need for it now.
PrEP isn’t going to be right for everyone. PrEP isn’t a magic bullet that is going to end all new HIV infections. PrEP doesn’t address the growing concern around rising rates of other STIs.
But PrEP works. PrEP is cost effective. We need to have PrEP now.
Matthew Hodson is the chief executive for NAM.
This article was first read/performed at “Let’s Talk About Gay Sex and Drugs” (the PrEP-themed September edition.)