June 15, 2015

Sex without Fear




Left: “I equate PrEP to the Pill. People had a backlash against it at first, thinking it would lead to promiscuity. I’m being a pioneer and a guinea pig, and why not?” —Nathan
Right: “I use condoms but not with one guy, a friend with benefits. I’m HIV-negative, and he is, too, to my knowledge, but I’d consider going on PrEP to be more cautious. I can get it through my mom’s insurance.” —Sherrod   

Gabriel and his friends like to go dancing at places in Chelsea and Hell’s Kitchen like Viva and Pacha. One night last winter, they ended up at a downtown club hosting a circuit party, a huge gay rave with throbbing, industrial house music. The theme was leather and S&M, and Gabriel* wore a singlet. He’s usually the least interested in drinking of the group­—he’s the responsible planner—but as the night wore on, he wound up becoming very drunk and very high and making out with lots of men. “I was feeling the fantasy of it all,” he says. A couple he vaguely knew grabbed him. They wanted to do more, insistently. Gabriel resisted at first and then, he says, decided to just give in to the spirit of the evening. It felt, at the time, freeing and hedonistic. 
But he hadn’t been wearing a condom when they had sex, and in the morning, he woke up wanting nothing more than to regain control over that moment. Gabriel is a 32-year-old real-estate broker. He had tested negative for HIV the last time he’d been to a clinic. Terrified that might change, he went to Callen-Lorde, a health clinic in Chelsea, where he was placed on a 28-day course of a full HIV-medication regimen. When taken within three days of exposure, it dramatically reduces the chances of infection—something like the morning-after pill for HIV. Gabriel didn’t react well to the course: He felt nauseous and drained the whole time. 
He never wanted to go through that again—neither the physical or the psychological anguish. So Gabriel got a prescription from his doctor for Truvada. Truvada is a ten-year-old HIV-treatment pill that, in 2012, quietly became the first drug to be approved by the FDA for a new use: to prevent HIV infection. The drug has the potential to dramatically alter the sexual behavior—and psychology—of a generation. When taken every day, it’s been shown in a major study to be up to 99 percent effective. For Gabriel, it was like switching to birth control instead of Plan B. 
Several months after starting the drug, Gabriel says it’s allowed him to be bolder and more unapologetic in his desires, to have the kind of joyfully promiscuous, liberated sex that men enjoyed with one another in the decade or so after the Stonewall riots brought gay life out from the shadows and before the AIDS crisis shrouded it in new, darker ones. 
For some men, Truvada’s new use seems just as revolutionary for sex as it is for medicine. “I’m not scared of sex for the first time in my life, ever. That’s been an adrenaline rush,” says Damon L. Jacobs, 43, a therapist who has chronicled his own experience with the drug on Facebook so enthusiastically that some assume Gilead, the drug’s manufacturer, must be paying him. (It’s not, say both he and Gilead.)
“I stayed the night with a guy I knew, whom I believe to be HIV-negative,” he tells me. “We passed out, too drunk to fuck.” In the morning, they tried again, without a condom. “He was getting close to coming,” Jacobs relates, “and he said, ‘Do you want me to pull out?’ and I said, ‘No.’ I thought, I want this experience. I deserve this.”

For the past several years, the conversation about gay life has been, to a large degree, a conversation about gay marriage. This summer—on social media, on Fire Island, at the Christopher Street pier, and in certain cohorts around the ­country—what many gay men are talking about among themselves is Truvada. And what’s surprising them is how fraught the conversation can be. For some, like Jacobs, the advent of this drug is nothing short of miraculous, freeing bodies and minds. For doctors, public-health officials, and politicians, it is a highly promising tool for stopping the spread of HIV.
But for others, a drug that can alleviate so much anxiety around sex is itself a source of concern. They worry that Truvada will invite men to have as much condom­less sex as they want, which could lead to a rise in diseases like syphilis. Or they fret that not everyone will take it as religiously as they ought to, reducing its effectiveness and maybe even creating resistance to the drug if those users later become HIV-positive and need it for treatment. And just as the birth-control pill caused single women in the sixties to wonder whether they’d be seen as “sluts” and to internalize that real and imagined shame, some gay men wonder how Truvada will play in the straight world; it sends a strikingly different message from the one in the “Sunday Styles” wedding announcements. Other gay men worry that the very existence of such a drug is a kind of betrayal: of those who’ve died in the epidemic; of fealty to the condom, an object alternately evoking fear and resilience, hot sex and safe-sex fatigue; and of a mind-set of sexual prudence that has governed gay-male life since the early ’80s. Even after treatments for HIV made it a manageable disease for many, gay men have absorbed the message that a latex sheath is all that stands between them and the abyss. Meaning not only HIV infection but everything it implies: loss of self-control and personal dignity, abdication of civic responsibility.


This is the Future a new Chapter

They ended up taking baths together all winter long. But it was only in March, when they were both in New Orleans for Mardi Gras, that they fell in love. “I realized,” says Herrera, who previously had found Beard a little dour, “that a New York winter is not the time to see the best in someone.”
When they got back to the city, Herrera was faced with a dilemma. He wanted them to sleep together without a condom, but Beard’s HIV undetectability wasn’t enough to ease his mind. Herrera started looking into going on PrEP. 
“I felt an incredible loss of control, constrained,” says Herrera. “I thought previously I’d go on PrEP for every slut in New York City, then I found myself thinking of going on it for just one guy. I felt like I was being pulled into a big public-health trend, not to mention Gilead’s coy indirect marketing. Was it really the best thing for me?”
Beard would say to Herrera only that it was his body and his decision to make, but says he wasn’t comfortable having condomless sex, as a top, unless Truvada was involved. 
Herrera went through the paperwork of getting on an Obamacare plan and going on PrEP. “I was a Latino immigrant who grew up without health care,” he says, “and finally I had a reason to be in a health structure and go to the doctor and get checked up every three months.” He took his first dose of PrEP with a huge can of Sixpoint beer and posted on Facebook a picture of the can alongside the Truvada bottle. One friend posted a frowny-face (perhaps thinking Herrera had HIV), but another wrote, “The future is now!” while yet another PrEP-taker said he liked to take his with a mimosa.
After ten days, once they were sure the Truvada had kicked in, Beard penetrated Herrera without a condom. “I was afraid I was going to hurt him,” says Beard. “I was dazed all day after,” Herrera replies. He smiles.
Homosexuality is separated from heterosexuality by the simple matter of whom one desires. And for 50 years, gay men have experienced an extreme series of turnabouts in their collective sexual psychology. The closets of the pre-Stonewall period gave way to the abandon of the ’70s, which was met with death and then shame and anxiety. And now? I ask Herrera how he felt about being on PrEP after what he called “the temper tantrum in my head” he’d experienced before starting the treatment—one in which it seemed like the various debates of the last half-century of gay sexuality were colliding, in miniature, as he made this one decision. 
He pauses. “It feels like the future, like a new chapter,” he says. Then Herrera surprises us by starting to cry. After all, a powerful history of desire and dread intertwined is not easily undone. “I feel very proud because a lot of men have died for me to be able to do this,” he says. 
Beard takes Herrera’s hand. “Leo thinks out loud,” he says. And then, to me, “Why should we continue punishing ourselves?”

 3 yrs after this picture was taken
at a Manager’s conference, I stopped smiling.
These two stories out of a six story appearing at nymag.com with the same theme, sex without fear.
 I picked the first and the last because I believe it represents the point of where we are in the history of HIV and stopping the transmission without stopping the sex lives of people that are in nature very sensual and aware of the mental implications on gay sex. Yes all sex starts with the mind but it doesn’t end there. Gay sex because the stigma that was attached to it and still is in many minds, it becomes more important than just an orgasm. When you put your life on the line to accomplish something with another man it just doesn’t get more important or mind boggling than that. This is as personal as it gets, sex between two men.

We have beg, fought and marched to get science to catch up with this just like it has with other viral epidemics. With a late start and always a lack of funding we are at the point in which rate numbers in many places have stopped going up and in some down. New York City an example of how hard it can hit when you have so many subjects, it’s managed to control these rates on the sex equation of it and that alone is a message to those places in which the rates are going up which in many instances in places where there were little reporting and lots of denial. Still NYC serves as an example that they can get on top of it. I don’t want this piece to be an argument of numbers instead I want to bring forth something that we should be talking about sex without fear; Sex is good and it can be safe and condom-less. Condoms had their time but they were never made for gay sex and never 100% effective.
My fear my sex

The second time that I can remember having sex in a particular sexual position or way with another man and having both wear condoms, still I became HIV. My next relationship two years after that was with a man who was HIV-. Condoms had to be the answer and they had to work every time for my sanity and protection of my partner. This time they worked. My sex life was lacking and no matter how much intercourse I had with my partner it took so much control over my mind not to think of what if it breaks? question. 
What ever information about the safety in oral sex was not made public so there I was denying him something he wanted very badly and he was willing but I was not, he probably got it someplace else. I split up because he was a bad partner. No the one to grow old with. but the one that will make you old. There are other reasons but for his privacy’s sake I wont go into details. He had too many issues being the gay son of alcoholic, homophobic parents. Sadly enough his next partner was also HIV but there was no condoms and he ended up becoming HIV. 

Had Prep been available then, Im sure he would have not turn with his next partner and I would have broken up with him a lot sooner than sticking it out with a guy that was killing me without a gun. I stuck it out with him for 5 years because I didn’t think anyone else would want me. Those five years cost me so much in every way you can think. If I thought of the price I paid for this relationship I could not finish writing this piece, is that emotional with me still. I refused an HIV- partner after that and that shrunk the pool of decent kind of guys that could be available to me. Guys with the normal luggage and everyday problems.

Editorial

I am so happy no guy particularly guys above 30 and single have to go through what I experienced. I think is time we put a tap on the fear and tapped it out. Wether you are negative today or positive, go for the man not the disease. Its better an HIV+ partner than a lier, obese, gym bunny,alcoholic, cheater, drug, computer, porno, Fb addict.  I’m open to an HIV- negative guy but one word out of place at the beginning makes me assume(yes assume) he might not be educated in this disease and I could not start from scratch again. The truth is and some people would want my hide for saying this but many HIV guys have a lot of issues they have not dealt with. They have made themselves damaged. They went for bad habits in order to survive and thinking they never had a future. I know it because I did. I never planned one day ahead never for the future because I thought I had none. I let life just pass me on by.  Didn’t become a full alcoholic nor a druggie but I was damaged in other ways. 
Not damaged anymore because I know the truths and you know the truth will set you free. I’m free of most of my fear. Im free of religion, gods, lies, etc. I try to be tuned to the earth and the spirit. These things you can do without posting false messages on Facebook or trying to feel better by selling snake oil.  It is wrong to be telling people their life will be good if they have faith or believe in this or that. Gays of all people you would expect to know better. But as an HIV person, some try to hold on into anything for help. You will never know what that is unless you became HIV, particularly from 10-30 yrs ago. Sex, Religion and politics are personal. But only sex and religion have to do with the heart, no one has the right to prescribe to you on those unless asked for particular help.

 My truth is mine because I found it. Your truth might be different and it might not be with loving Christ and the Pastor but surely it has to do with fear. Only you will know. One shoe size does not fits all.  You don’t dwell in what you don’t know today  you might figure out tomorrow. I get better everyday without the fear of tomorrow. Im starting to plan again. The problem is I have wasted much valuable time trying to find answers that only life was going to give me on its own time. 

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