When we talk about stigma and PrEP, the question we should be asking is, “Just what is it we are ashamed of?” Is it the sex? The gay sex? Or is it the realization that gay men find pleasure and fulfillment in anal sex and fluid exchange?
Didn’t we have this conversation in the beginning of the epidemic, when the general public tried to make sense of what gay men do in bed? Jaws were agape and there was collective clutching of pearls when people realized that not only did we participate in acts seen as “deviant,” but we really, really enjoyed them.
Many of the negative attitudes attached to PrEP—the strategy of taking an antiretroviral pill every day to prevent HIV—arise from the presumed sexual behavior of the person taking it. Some people believe that it will promote reckless sexual behavior or promiscuity, insisting that PrEP is only for so-called sluts, and that those on PrEP are just “Truvada Whores.”
This moralizing only serves to undermine our efforts to promote the health and well-being of gay and bisexual men. “Promiscuity” is an arbitrary construct whose only purpose is to shame people for their sexual behavior. (One person’s whore is another person’s prude.) It’s time to do away with the word, as it is about as timely as corsets and powdered wigs. The best way to push back against this sort of slut-shaming is to reclaim “slut,” as we did with the word “queer.”
There is no evidence to suggest that PrEP will increase risky behavior or lead to sexual anarchy. We’ve heard this all before. Condoms do not promote promiscuity, watching Glee doesn’t turn kids gay, and listening to rap music doesn’t make you a thug.
In the beginning of the epidemic, safer sex education was about giving people as much information as possible so they could make informed decisions about preventing HIV. But prevention education was constantly under attack from government, churches, and PTAs. Back then the condom was the culprit. The Catholic Church was, and still is, a staunch opponent of condoms. Activists heroically stood up to the church, as documented in How To Survive A Plague, because it was understood that denying people access to information and stigmatizing their sexuality was unjust and only made the epidemic worse. (Our movement is a history of sluts and deviants. Gay sluts don’t just vote, we organize.)
In the ‘80s, HIV stigma and homophobia was much more obvious when coming from the church or people like Jesse Helms as he blamed the epidemic on our “unnatural acts.” But now it’s much more insidious—much of the stigma today comes from our own community. In a New York Times opinion piece, Dan Savage, when talking about gay men and PrEP, said, “The guys these sensible health care folks are trying to reach are not sensible. They are self-identified idiots who can only be saved by a vaccine.” Just what is the point of calling gay men “whores” or “stupid”? It’s about as useful as Rush Limbaugh hurling the term “slut” at advocates of contraception.
To stigmatize is to delegitimize. The diversity of gay male sexuality is valuable. Since before Stonewall, we have fought to demonstrate that our humanity and our sexuality matter. We should be focused on various ways to foster sexual health while reducing harm, not on codifying specific behaviors as morally taboo. Let’s support gay men as they explore the various and (thank goodness) growing number of HIV prevention options at their disposal, while encouraging the cultivation of fulfilling and healthy sex lives. And let’s call out members of our community, like Savage and Duran, when they stigmatize PrEP and the gay men who use it.
One of the best ways to combat stigma is by demonstrating our resilience. We can show people that HIV, PrEP, and gay sex are nothing to be ashamed of. We can educate negative gay men so they can be their own best advocates around PrEP. We can work with doctors and providers so that they are informed about PrEP and don’t allow ignorance or bias to prevent them from giving gay men the quality care we need and deserve. And we can urge gay men on PrEP to speak openly and honestly about taking PrEP—because there’s no shame in it.
We’ve all experienced some form of stigma in our lives. As an HIV-positive gay Latino, I have experienced my fair share. When I seroconverted I encountered stigma for being “stupid and slutty” enough to get HIV. Now negative men encounter stigma for being “stupid and slutty” enough to prevent HIV. Poz and neg men are comrades in the struggle against this epidemic, and the stigma that continues to surround it. We can choose to allow some people to tear down our community, or we can work together to build a stronger and healthier community where all gay men are healthy, find pleasure, and have improved quality of life.
Alex Garner is a writer, activist, and founding editor of Positive Frontiers.
click here to visit BETA