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If These Walls Could Talk

I’m a hard working Truvada Whore. My day job is at an HIV/AIDS non-profit as an HIV test counselor/recruiter, and my night job is at a sex club. Yes, a private club where dudes go to have sex. Isn’t that perfect? Sometimes I test someone for HIV in the afternoon, and then not two hours later, greet them as they enter my glory hole palace. You can’t make this stuff up!

I love being able to talk to people about PrEP at both of my jobs. Gay dudes have a lot of questions about it, and rightfully so. This is all very new and groundbreaking information. Most people I talk to these days have vaguely heard something about PrEP or Truvada out there in the world. When I’m doing HIV test counseling with my #TruvadaWhore t-shirt on, it often sparks a topic of conversation that the client might not have otherwise felt comfortable bringing up. There is a lot of misinformation out there (thank you Michael Weinstein) and it feels so great to be able to dispel some of that stigma and judgment with scientific facts from a variety of trusted sources (e.g. CDC, FDA & WHO). The guys I test tell me they feel more comfortable talking to a peer like me about PrEP, HIV risk, sex, etc. I have ongoing relationships with some of the guys who I’ve helped get hooked up with PrEP programs. What started out as my job ended up taking over my whole life, and I’m happy to service my community.

Customers at my night job have also stopped to ask me about my t-shirt. A well-known activist in the gay community here in SF even tweeted about how nice it was to meet me at the sex club wearing my t-shirt. While some of our older patrons misread it as #TruviaWhore, I do admit that stevia-based sugar substitutes are actually quite exciting. Even though this club is marketed primarily as a place where dudes can anonymously blow other dudes in a glory hole maze amid thumping house music, anal sex and beyond is also welcome. Past the piss bathtubs and 90s twink porn booths, you’ll find two slings set up in the dark labyrinth of Tom of Finland posters. Wherever there are slings, sloppy play is bound to happen.

We have “policies” in place to make sure our customers are engaging in “safer sex” practices. The SF DPH developed “minimum standards” for commercial sex venues to ensure that safer sex occurs in congregate public sex environments. This policy is a relic of the height of the HIV/AIDS crisis, when bathhouses were forcibly closed en masse.

While undeniably intrusive, I really don’t mind monitoring condom-use. A job is a job. When I’m on host duty, I refill the coffee, sweep peanut shells, make sure no one has passed out on poppers, and use a flashlight to see if guys who are having sex are using condoms. If they’re not, it’s my job as the condom cop to make them comply. Repeat offenders are kicked out. A good friend of mine teased me, “So you’re saying, if my beloved Truvada Whore catches me fucking bareback, he’ll kick me out of the club?” Didn’t Alanis Morissette write a song about this?

There’s a certain perspective that once a guy starts PrEP, he will begin to forgo condoms. There isn’t a lot of evidence to support this theory of risk compensation. This may or may not be true, but many people who are now on PrEP weren’t using condoms regularly to begin with. And if people on PrEP aren’t using condoms anymore, what’s the big deal? Results from iPrEx shows that daily Truvada adherence yields protection estimated at 99% when used under daily compliance. A PrEP prescription involves routine testing for STIs like chlamydia, gonorrhea, and syphilis. As more and more people on PrEP are getting tested and treated for these, the rates of new cases of STIs will likely decline. I believe that the test and treat model works. Makes sense, right? A new study also suggests that Truvada can lower infection rates of genital herpes. Michael Weinstein just died a little.

In May 2014, the CDC released their “Clinical Practice Guideline for Pre-Exposure Prophylaxis,” which recommended Truvada as PrEP for pretty much all sexually active HIV-negative MSM. The scientific community, doctors, therapists, and community activists have accepted that condoms aren’t being used regularly. People don’t like them. It’s 2014, and PrEP sex without condoms is the newest safer sex HIV prevention tool. As time goes by, I believe that the dominant opinion will shift that way too. There are loads of tools in our prevention toolkit. It can be sexy to talk about PrEP, condoms, undetectable viral loads, sero-positioning, and others. An individual has to be able to make the choice of what is going to work best for his own unique situation.