Anthony Burnside || THREE LITTLE PILLS

Mine is a very active sex life. It always has been, and I don’t plan to slow down. A sign given to me when I was 16 still hangs over my bed to this day: “Committed to Excellence”. It was a gift from my first lover because of my enthusiasm during sex. Now, 33 years later, I have some grey hairs but my sex drive is the same. For me, every time is fucking magic.

I lost my cherry before I was old enough to drive a car. I was 16, my PE teacher was 22. Back then, I was far more developed than most kids my age and, long story short, I had my first orgasm with another guy by blowing my load down his magical throat. A few hours later, I was pumping a load up his ass, and soon after that I had enough courage to roll over, let him inside me and I”m here to tell you: the first time his cock hit my prostate and I started shooting off no-handed I knew there was no turning back. commited And then, well, things got scary. A rare cancer was showing up in gay men, and it would be a couple more years before scientists would find the virus that would first be regrettably named GRID and soon renamed HIV. Panic and confusion ran rampant, and we were told in no uncertain terms that sex without a condom was playing Russian Roulette. Sooner or later…Pow! Your number was up, brother.

blogtimjackThis posed an interesting and painful problem for me. I say this at the risk of sounding like a braggart: I’m a big guy. When I finally stopped growing, I landed on 6 foot 6 inches. Nature also blessed me with an appropriately sized cock – a true 10 inches and 7 around. I had a better chance of seeing unicorns than finding a condom that would fit me. When I could get one on, it felt like my cock was being mugged. They were painful, hard to roll down, and slid off while I was fucking. So the fear of HIV dictated a very uncomfortable, unsatisfying sex life for years. And because I couldn’t get a condom to fit me, I went from being versatile to total bottom.

Flash forward a few years to the mid-1990s. The man who took my virginity is out of the picture and now I’m with a wonderful man who I love intently. He’s HIV positive–a fact I knew about him before I could spell his last name–and I’m not.

Together we had to find ways of discovering a satisfying sex life without my seroconverting. The meds of the day weren’t what they are now, and while there was no reason for us not to have sex, it came with a lot of caveats. We tried mutual masturbation (not satisfying); we tried me on top wearing a rubber (misery). We tried him on top, wearing a rubber (incapacitating performance anxiety on his part: “What if the condom breaks?”). Finally, we tried him watching while I fucked with other neg guys (alienating).

You get the idea. We loved each other but our sex sucked.

Skip forward to today. HIV isn’t the death sentence that it was 30 years ago. I’d just as soon not get it, but I don’t have a problem sleeping with positive guys. In fact, I’m repulsed by men who discriminate against a guy because of what is or isn’t in his blood.

They do make condoms bigger these days. The few times I’ve gone after some anonymous stud, condoms have been in the mix. Statistically speaking though, you’re more apt to get struck by lightning than contracting HIV from a poz guy on meds with an undetectable viral load. I like those odds–and I say that as someone who has an HIV/AIDS advocate since the days of being with a boyfriend who was HIV positive and a very vocal, visible member of ActUP.

But as a prevention strategy, condoms are not the best way for me to go. I’ve had more than three decades to come to that conclusion. I’ve had many encounters where condoms were discussed and discarded, and hormones took over. The risk of the behavior was–in the heat of the moment–far more inconsequential than my getting laid. Call me crazy, but if you’re a man you understand.

Enter PrEP. Pre-exposure prophylaxis. PrEP is antiretroviral medication used as a preventative measure for HIV negative people in order to stay negative.

What an out of the box thought, right? Lots of people aren’t using condoms, and these medications – if taken as they’re supposed to – have the potential to dramatically decrease the possibility of becoming HIV positive. According to some studies, PrEP can be 96% effective–which makes it more effective than condoms.

I think it’s positively brilliant. The science is sound, the medical side effects are minimal to non-existent, and in July of last year the FDA decided it’s a great idea too when Truvada was approved for use as PrEP.

So I’ve signed up for a local PrEP study and I’ve been accepted. Since the inception of the idea, I’ve been a huge advocate for PrEP, and it’ s time to put my money where my mouth is. For the next year I’ll be taking a combination of three pills daily to monitor their effectiveness in preventing HIV infection. Two of the pills make up Truvada (FTC and tenofovir) and the third will be Maraviroc; one that hasn’t been studied in depth regarding it’s effectiveness and safety for use in people without HIV.

Will there be side effects? Possibly, but that’s not too much of a concern as they usually pass over time as you continue to take the meds. There are layers upon layers of people and boards monitoring the safety of all participants, so I know I won’t be thrown in the deep end all on my own.

business And my sex life during the study? Business as usual. I know these pills aren’t going to make me 100% bulletproof against HIV–nothing short of complete celibacy will do that. But consider this: the HIV prevention message of “always use a condom” is over 30 years old. People change, lifestyles have changed and there’s a new generation coming up that hears that message without the urgency that I did when I was their age.

My son, who’s also gay, has been sexually active since he was 15. Up until the time I adopted him, he thought of HIV as a mythical beast that wasn’t a threat to his existence. As a father, the possibility of medications being readily available for him as an effective prevention measure against HIV is something I find very exciting and promising.

I’m also lucky in that my insurance pays for the meds, and the drug manufacturer actually has co-pay assistance. If I weren’t in the study, I would actually be taking them for free.

The very definition of safe sex is changing, and it needs to. Gay men aren’t using condoms, and it’s not about crafting a new message to make their importance more prevalent. The message needs to be changed to state that, while condoms can be effective, there’s another way to protect yourself. There are those in power who preach that a pharmacological solution to HIV is a disaster and will try to make you believe that everyone who’s got access to PrEP will toss their condoms away for good and shag like rabbits. They’ll try to tell you that Truvada and PrEP is a magical pill solution that does nothing more than give up on gay men.


To me, as well as anyone who’s truly studied Truvada, the practice of PrEP is along the same lines as birth control. Women who take it aren’t whores who’ll jump on every man with a pulse. They simply don’t want kids, and the pills are only effective so long as the regimen is followed strictly and correctly. My participation in this trial isn’t about my running down an orgiastic path of wanton sex. I simply want to embrace a way to keep myself negative, using an effective method other than condoms.

I’ve been advocating for PrEP since it became public knowledge, and my participation will give me a first-row experience of its effectiveness.

  1. Sorry for the delay in response, I didn’t get an email that you had posted again.

    The study itself is for 48 weeks, and the effects of the meds in general ONLY show up in patients who’ve taken the drugs for years and years. With one of the meds, kidney problems are expected after more than taking a decade of the pill.

    The answer to your other question isn’t a rosy one. PrEP is publicly available now, but it’s not cheap. If you have insurance, it could come out to be free depending on your plan as most of the pharmaceutical companies have copay assistance available. Insurance picks up most of the fee, the assistance picks up the rest and presto! You’re on the road no charge. If you have no insurance, then the out of pocket cost could be as high as $1200 bucks a month. These are the same meds any poz person would take, so they’re not giving them away on the cheap. The system works against those who’d probably need them most (for now)

    As a meager upside to that answer, there are 2000 people involved in this study, just in the city I live in, so they’re receiving the meds free for a year. I believe (don’t hold me to it) that this study nationwide has enrolled 16000 people in total.

    Hope that answers your questions

  2. An interesting post, no doubt. As the writer states, there are more alternatives now (or more being explored anyway), but I do think that there still needs to be a little more caution about the side effects of the ‘three little pills,’ especially since what those effects are aren’t completely know.

    1. The side effects actually are known and well documented, as I am taking the same ARV’s prescribed to most HIV positive men. It was part of more than one meeting with the study directors that I understand the possible side effects I could expect. Most of the study participants aren’t experiencing any side effects at all. As of today, I’ve had small bouts of random dizziness and nausea, both of which I saw coming.

      1. That is good to hear, Anthony. However, two related questions (mainly from my ignorance, really): 1) How long term are the studies and the effects and 2) How available is the treatment across the community (and here I’m thinking specifically about race and class)?

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