5 Reasons I’m on PrEP But Still Don’t Do Bareback

“Why the hell are you on PrEP if you don’t do bareback?”

I started taking Truvada — the only drug so far approved for pre-exposure prophylaxis, which greatly reduces the chance of HIV-negative folks becoming infected — a few months ago and have been asked this question ever since. For many gay and bi men I’ve talked to on Grindr, taking a daily pill for PrEP can seem like an unnecessary hassle and an unwarranted waste of money if you aren’t also having condomless sex. The fact of the matter is, I am devoted to PrEP, but I have absolutely no interest in doing bareback. If you’re anything like me and you have to field questions like this with some frequency, here are some good justifications to cite:

1. PrEP relieves my HIV anxiety.
Queer men of our generation were taught by the survivors of the AIDS crisis to be careful. If you lived in the 1980s, an HIV diagnosis meant death. Today, the newly diagnosed can live as long as HIV-negative people. This shift is the product of older gay men’s relentless advocacy for safe sex and precaution. The by-product, though, is that we are now a generation of serophobes; an entire population of people who get tested at least four times a year and would never so much as kiss someone who’s poz. In the contemporary gay imagination, and despite all evidence to the contrary, in our minds HIV still means the certain deaths depicted in Rent, Philadelphia, And the Band Played On,and The Normal Heart.

In other words, despite medical advances, the waiting room in an LGBT health clinic still feels like a martial tribunal in a Soviet state. Personally, I don’t think I will ever fully grow out of this anxiety. But PrEP helps ease the stress.

2. Condoms protect against other STDs.
Every sexual encounter is a calculated risk. No matter how safe you are, there will always be some danger. There was a terrifying rise for chlamydia and gonorrhea rates in 2014 — the first in years — at the same time that syphilis rates shot up. Even with PrEP, as a gay man 'm at still at high risk for these sexually transmitted diseases, all of which can be effectively protected against by wearing condoms. While condoms do little to protect against HPV and herpes, those are just the hazards of sexual activity.

3. PrEP can be affordable, i.e., free.
I've had a few guys chide me as wasting money on PrEP if I didn’t plan on putting it to full use. But the truth of the matter is that PrEP has amazing payment assistance programs for people without insurance as well as programs that will cover most deductibles and co-pays for those who are insured.

4. PrEP helps prepare for the worst.
What if the condom breaks? What if this guy is poz but doesn’t know it? Is it rude if I ask to see his most recent test results? What if someone assaults me and I catch something from them?

These worries are offshoots of the HIV anxiety impressed upon us by the previous generation. But it’s not pure paranoia — gay men are twice as likely as their straight counterparts to experience sexual violence in their lifetime, and errors in condom use are extremely common, leading to breakage and unexpected leakage. On top of all that, one in eight Americans with HIV don’t know they have it.

I know my chances of exposure to HIV are very slim if I use a condom every time, and I know most of my anxiety is irrational. But for me, even when giving fate the benefit of the doubt, I can trust that PrEP will help me prepare for the worst.

5. It’s my choice.
At the end of the day, the best defense I have against critics of my sexual choices is: Get lost. If I don’t feel comfortable doing bareback even though I’m on PrEP, that’s my prerogative, even if I can’t always justify it with numbers and facts. At the end of the day, the only person I have to answer to for my sexual decisions is myself. So don’t ever have sex if you’re uncomfortable with the terms of it. It’s your body, reader. It is always your choice what to do with it.

DREW KISER is an editorial intern for The Advocate. Follow him on Twitter @DrewKiser666.