Originally Posted By Brian Webb on Homoculture.ca
Pre-exposure prophylaxis, known as PrEP, is slowly becoming more known in the gay community. As further studies and research is done, more organizations are endorsing its use to protect against HIV. The gay porn industry has been watching the roll-out and adult entertainment models are taking notice, that it’s now an option available to them to further protect themselves.
“The original reason I started taking PrEP, was at the time I was dating someone who is HIV positive and undetectable,” explained gay porn star, Max Cameron. “At the time, I was still somewhat concerned. I prefer condomless sex, like many gay adults. I wanted to protect myself in case he fell behind in his meds or started to develop a viral load above 200 copies /ml again.”
This is a real concern for many gay couples who’s HIV status is not the same. The option of PrEP as an option for safer-sex can now be an option for many gay men.
“I had also been flirting with the idea of doing porn,” Max Cameron continued, giving even more reasons why he wanted to start on PrEP. “My ex boyfriend was in porn working for Treasure Island. All their stuff is bareback. I know the last test results of all my scene partners and you always assume their status is positive. I understand the testing protocols and knew my risk. I wanted to make sure I protect my health. After all condom efficacy ranges between 55-85%, while my PrEP regime protects me beyond 99%efficacy because I’m adhering perfectly.”
There has been much discussion about guys starting to take PrEP as an excuse to discontinue condoms and have unsafe or bareback sex. The reality is PrEP is safter / protected sex even when condomless. With condoms and PrEP we could still call it safer-sex. As the studies have also shown, those who take PrEP haven’t changed their behaviours. They use it as a new method to protect themselves. PrEP hits real world health issues with the HIV epidemic where solely relying on condom idealism seems somewhat reckless now.”
“A lot of my habits haven’t changed much,” said Max Cameron. “I have always preferred bareback sex, either bottom or topping. It’s much more comfortable. Before I was on PrEP I was pretty risky. You take peoples word, based on their status. I always respect if my partner wants to use condoms during anal sex, or has the idea in their head that they want to have sex with a condom.”
The reality is, we have been trained for over two decades to believe that condoms are the single source for safer sex. The fact is, that’s old school thinking. There are many, many options when it comes to safer-sex. PrEP sex is safer sex!
“People who lived through the ’80′s who experienced and lived through the countless HIV deaths, I guarantee you anyone who was HIV negative would have been on it,” stated Max Cameron, reflecting back on HIV crisis, which instilled fear, escalated the use of condoms and sexual education. “When you get HIV now, it’s not a death sentence. People live completely normal lives. It takes some emphasis away from [PrEP]. I don’t understand why people are attacking it. The older generation who lived through the 80’s would say that if it existed then, they would have been on it.”
Just because you don’t use a physical barrier, like a condom, doesn’t mean your not having safer sex. People who want to proactively protect themselves are more than willing to take a pill daily, because they take their health seriously.
Studies have shown that daily adherence of PrEP can reduce the risk of HIV by as much as 99% when daily every single day, up to 96% when taken four times a week, and drops to 76% when taken only twice a week. The current standard is for a daily dose for maximum effectiveness. Jurisdictions need to set their own rules and guidelines, which Canada is lagging behind the United States on the use of PrEP.
“I’ve taken it every day since February 2013 and I have yet to miss a dose,” explained Max Cameron. “If it did happen that you did forget one dose it isn’t the end of the world.”
When it comes to adherence, it’s easier to take a pill once a day with breakfast, at lunch or after dinner. It becomes part of your daily routine. It’s taken when you are of sound mind. Unlike condoms, which could break, be put on incorrectly, or not used at all, especially after a night out of drinking, when most incidents of HIV exposure happen.
“PrEP is an amazing option,” said Max Cameron, referring to how PrEP could change the gay porn industry. “You will see more companies promoting the use of Truvada. Models who are HIV negative will be jumping on board. It will change things in the industry for the better. It’s kind of a trend that porn is going; more barebacking. This is just another tool in our arsenal to help with HIV prevention. If we are practicing bareback sex, we should be promoting safer sex, but using other forms of safer sex, like PrEP.”
Max Cameron isn’t the only advocate for the use of PrEP in the adult entertainment industry. One of the top gay porn directors, Mr Pam, has spoken openly about PrEP and is optimistic about the use of the anti retroviral drug treatment.
“Most people are open to discussion about PrEP, whether it’s their personal opinion or not,” says Max Cameron. “It really is like the inception of birth control, when people shamed the women who used it, call them whores. The same thing is happening here. Once people come to understand it and get over the fear of the unknown, with knowledge, then you’ll see the stigmatization drop off.”
If you you think you are at high risk of HIV, talk to your doctor. PrEP could be a solution for you. It’s not for everyone, and not everyone needs to take it. It’s just another option available for people who want to take control of their health.
I am very pleased that Prep is an available option for Men who engage in high risk sex however I am very concerned about the message that is being conveyed along with it about appropriate use and the truth of how the porn industry sets the trends in what behaviour is percieved as ‘normal’ gay male sexual expression. I accept that a percentage of men are engaging in bareback sex now and always have been and the proof is in the rates of STI tranmissions particularly HIV, which is now and has always been much higher for MWHSM. Prep has the potential of protecting sero discordent couples as well which is fantastic. The downside is the message been conveyed about condoms which is inaccurate and based on dubious studies primarily reliant on self reporting. There is also a myth being perveyed by Prep advocates that Prep doesn’t encourage an increase in high risk sexual behaviours and this is simply wrong and nothing more than propaganda. The efficacy of condoms used properly and consistantly as Prep is at least as protective and often more protective. What is to be gained by running down condoms as a protection against almost all STI’s while promoting Prep without addressing Prep’s risks which exist even for those who adhere to its prescribed proper use regime. The consequences of this will be felt for at least a generation if this message of ‘Prep=Good’, ‘condoms=bad, old fashioned, ineffective’. I can site any number of credible studies proving the Prep is a poor substitute for Condom protection but that doesn’t help anyone as it is potentially a great partner in the fight to improve the health of Gay Men. Stop runnning down Condom use as a sensible protection method for the majority of men, accept that bareback sex is still potentially trecherours as anyone reading your article would believe you are stating that BB is completely safe just as long as you are making Gillead rich and taking Prep.