PrEP posters, © ACT UP London


PrEP posters, © ACT UP London


PrEP posters, © ACT UP London.


© ACT UP London


© ACT UP London

Why is PrEP such a big step towards sexual liberation?

Fernando Mariano

Let’s start by spotting the difference. What the hell is the difference between PEP and PrEP? PEP (Post Exposure Prophylaxis) is a cocktail of pills you can take if you have been recently exposed to HIV, to reduce the chance the virus will take hold. PEP is available free in any GUM clinic and the NHS covers it.

OK, then what the hell is PrEP? PrEP (Pre Exposure Prophylaxis) is a recent discovery of using HIV medicine by HIV negative people. It involves taking one pill a day of Truvada - a widely used antiretroviral medicine taken by HIV positive people. PrEP was proved effective in several studies. When taken correctly by negative people, it reduced the risk of HIV infection by up to 86% to 99%, depending on the study. There are currently only about 500 gay guys with access to PrEP in the UK, and I am one of them. I am taking part in a UK study called PROUD, that has already proved these pills to be at least 86% effective. The Department of Health has not approved PrEP yet because for some people it is still controversial. They worry people will stop using condoms and they worry about cost. But the fears that PrEP users will switch to always having bareback sex have not been born by PROUD - actually, people take fewer risks.

There are two poets I like to refer to when thinking about this issue. One is the great Eduardo Galeano who has sadly gone to dust, but to whom I am very grateful for all the wisdom he left behind, such as:

“The Church says the body is a sin,
Science says the body is a machine,
Advertising says the body is a business,
The body says: I am a party.”

The second poet I like to refer to is the forever-glamorous Lesley Gore with her invincible lyric, “It’s my party and I’ll cry if I want to.”

Governments must stop legislating over our bodies. The concept that the only thing you own is your own body must be understood. Discounting all the dogmas that capitalism has installed in all of us, our bodies are the only things we really own. That freedom should be respected and it is not the place for authorities to impose laws about what should people wear, how they should behave, how they should live their sexual and love lives, or ultimately what drugs they should take or not.

PrEP is not for everyone – but neither is marijuana is not for everyone. If making either of these accessible has the possibility of making people more fulfilled and happy why should other people’s morals or personal conduct preferences interfere?
Again using the marijuana comparison, PrEP is unlikely to be something anyone uses forever. I’ve smoked a lot of pot in my life and I don’t do it anymore. It just doesn’t make sense in my life anymore. Probably no one will be on PrEP for the rest of their lives either: people’s circumstances change, boyfriends come and go, sometimes sex happens more and sometimes less, using condoms matters less in some situations or becomes more important in others. Life fluctuates and we should embrace that. Embracing a new form of protection for some people to use sometimes does not mean that everyone is obliged to do this. Your body is your party - if Lesley could we all can! Explore it however YOU want.

PrEP doesn't make you high and its worries for the government are very different from those of marijuana. However, they have similarities. One of the reasons I believe marijuana should be legalized is that the drug quality control would be made by the State and this would positively affect users’ health.
With PrEP, control is again a key word. PrEP does not protect you from other STIs, true, however it means you go to the doctor regularly. People who don’t know their status contribute to the biggest percentage of new HIV infections in the UK. This is because when you are aware of any problem with your body, in most cases you will naturally take more care to not cause harm to anyone else, and this applies to any STI. If you are on PrEP, it also means that you go to the doctor every three months to grab your pills and to get yourself tested for all STD’s. So on PrEP you are ultimately safer than the average citizen who uses a condom to fuck but does not go to the doctor regularly and still sucks cock or pussy with no protection. And let’s get real, not many of us use condoms or a silicone sheet, whatever we suck on. Safe sex does not exist, it can only be safer or less safe, and as Lesley says, you should decide what you do in your own party; the system’s function is to provide the spectrum of different people with different options for full happiness and fulfilment.

Pulling the string of happiness, I return to Eduardo Galeano and his poem about fear (and love):

“The fear of silence rattles the streets.
Fear threatens:
If you love, you get AIDS.
If you smoke, you get cancer.
If you breathe, you get polluted.
If you drink, you get accidents.
If you eat, you get cholesterol.
If you speak up, you get fired.
If you walk, you get mugged.
If you think, you get worried.
If you doubt, you get crazy.
If you feel, you get lonely."

Fear affects all of us in different manners: to some it has a freezing effect, to others it makes us horny, but for most its absence means happiness and fulfilment. Galeano gets the point of social fear connected to basic human pleasures very clear, and his phrase ‘if you love, you get AIDS’ couldn’t be more spot on when discussing this subject.

I am a post AIDS-era baby, but following my research on those who lived before AIDS, I feel fear was a lot less present in people’s intimacy than it is today. HIV injected panic into intimacy and this is absolutely understandable, people were dying and the most sincere act of love and devotion could mean killing your beloved or vice-versa, and that is scary. However, technology eases things for us, and accepting new advances is not a bad thing, if used with as a weapon of protection and with total awareness of the level of risk you are putting your party into.

I dare to say with no shame that barebacking is absolutely delicious. Personally it affects enormously the level of intimacy I have with my partner and how I feel the unique and incredible experience of sharing my body. I am not preaching barebacking as the future, I am only assuming it as a valid sexual practice, and if technology can help me to live my sexuality without oppression and fear, why should anyone preach the contrary? It is MY party!

When I say PrEP can mean sexual liberation, I do not mean liberation from condom, but liberation to run your party - and your life - as you wish and with full responsibility. Making sure no one will hurt and that you are in absolute control of every consequence of your party is not only a responsible act but also an act of empowerment over your own body, and your own decisions as a love maker. Ultimately that is sexual liberation. That was the struggle of our hippie comrades in the 60’s when fighting in the love and peace movement.

The gay community has been the one that suffered the most with HIV since the 80’s. The fact the government ignored us on this issue for such a long time gave us a sense of community, and gave us the opportunity to lead the way on resisting, and ultimately saving the world from a plague that would have extinguished humanity in a blink. If we led the way when our lovers and friends were dying then there is no reason why we shouldn’t keep on doing this until we eradicate this pandemic, now that our lovers and friends can manage this condition and be here to support us.

The PROUD study showed that eight in every hundred gay men at high risk in London will become HIV positive this year, so if any extra tool is available to reduce this numbers, bring it on! PrEP is not expensive compared to the cost of treating HIV - and it will get dramatically cheaper in 2017.

Condom-less sex will always exist, because in a world of hedonism, things that feel good never extinct. Let’s not avoid the truth; let’s use it for our own empowerment. If the system holds a solution for people to do whatever they want, far from oppression and further away from fear and discomfort, and above all if this solution helps them to keep healthy, it should be provided immediately. The function of the law is to provide enough safety for people to run their lives as they wish and not to control their bodies or their choices.

If anyone that has the power to reduce suffering and heighten pleasure does not do so, he or she is the real criminal. Having the right to rule your party doesn’t mean to hold the right of ruling the other’s. In my party no one cries but me! And only if I want to!

Fernando Mariano is a performer, activist, social disturber, and member of ACT UP London.