In-spite Facebook and Ambulance Chaser Lawyers PREP Helps The Anxiety and Protects U from HIV
"The More You read the more you know, the better the chances to fight any untruth which will put you on the wrong track to an accident or death" (AG)
By Tim Fitzsimons
When HIV first tore into America’s gay male community in the early 1980s, quotidian questions of sex, love, lust, and trust transformed into weighty decisions with potential life-or-death consequences.
The decision to stop using condoms with a serious partner? Only as reliable an HIV-prevention method as your partner’s fidelity. A single instance of cheating? An indiscretion that carries the risk of an incurable and deadly disease. A random hookup? A nagging sense that, perhaps, this time was the time.
Todd Faircloth, 52, remembers those days well. In 1987, when gay men were still dying from AIDS in large numbers, Faircloth moved to New York City from North Carolina to start his big, gay life. He was just 17.
“I didn’t know anyone that lived past the age of 30, I didn’t anticipate anyone was going to live that long,” Faircloth, who now lives in Georgia with his husband, said. “It got to the point where people just assumed they all had a death sentence over their heads.”
He said he endured “hundreds” of AIDS funerals with a lot of dark humor, but still, “it was really scary to be out there.”
Amidst all the death, the human immunodeficiency virus caused understandable fear and anxiety among gay men, and Faircloth said this even influenced the relationships people entered into. “If you meet someone, you got with them, you were more likely to want to stay with them, not because you wanted to be with them, but because you're scared to go back out,” he said.
Today, more than three decades after Faircloth moved to New York, HIV is controllable with medication and need not lead to death. In addition to condoms, first approved to stop HIV in 1987, people at risk of acquiring HIV today can take medications like Truvada to prevent the virus’ transmission, namely pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP), which are taken before and after sex, respectively, to prevent HIV transmission. And for those who already have the virus, treatment as prevention, or TasP, makes it impossible to transmit the virus in sex when taken regularly, according to the Centers for Disease Control and Prevention.
One unintended benefit of this new array of pharmaceutical prevention options, according to a new study, is a reduction in “HIV anxiety.” Anxiety about HIV transmission, which the study’s authors describe as a “common” experience of gay and bisexual men — especially those who, like Faircloth, lived through the darkest days of the AIDS epidemic — can compromise their “emotional well-being and create barriers to HIV testing.”
For years, Lenti avoided taking an HIV test because of his fear that it would return positive. To this day, Lenti said, it is hard for him to take an HIV test and to trust potential partners because of his fears from the epidemic’s early days.
“It was a foregone conclusion that I would become infected,” Lenti said of his thinking at the time. Yet despite all that worrying, he remains negative. “I think the biggest fear that I had about HIV was not the fear of being sick. It was always the fear of dying alone,” Lenti said. “It’s just very hard for me to trust people, and I think you could argue that a lot of that stems from my fear of becoming infected, even though now there are so many different ways to combat that.” ‘I don’t think it just changes overnight’ because he suffered from its rare gastrointestinal side effects, he said he counsels many of his friends to take the daily medication.
“If you can take a pill that has a 99 percent effective rate, why wouldn't you do that?” he said.
However, most at-risk Americans aren’t taking PrEP for a variety of other reasons — its high cost (a 30-day supply could cost $2,000), privacy fears and worries that the drug is dangerous (a misconception fueled in part by online ads widely criticized as deceptive). According to the CDC, PrEP is only reaching 18 percent of the 1.2 million Americans recommended to take it, and so HIV anxiety persists to this day for hundreds of thousands of gay men.
Levi, a 19-year-old college student in Ohio, is among the nearly 1 million Americans recommended to take, but not taking, PrEP. Because he’s a man who has sex with other men and is 28 or younger, he’s considered at high risk of contracting HIV, according to the CDC risk assessment worksheet for doctors (the worksheet is based on a point system and uses a variety of risk factors).
Levi is no stranger to HIV anxiety. He recalled a recent incident after he performed oral sex where he began to worry, “Do I need to get a test?” “I spent the night basically in a hypochondriac fit running around looking if there are any sort of symptoms I should be looking for,” he said, telling an all-too-common tale. However, he needn’t have worried, as there is “little to no risk” of acquiring HIV through oral sex, according to the CDC.
Levi, who asked not to have his full name printed because he is still on his parents’ insurance and worries they would object to PrEP, said he’s just starting to think about taking the HIV prevention pill. He said the man he is dating is HIV-negative, and even though they plan to be monogamous, he doesn’t know if he can fully trust him, because the stakes are so high. “Is there anything that I could even ask for?”
Levi wondered. “Could you show me a paper or something? And could I even believe that?” Levi’s struggle to answer this question is as old as the virus, Halkitis said.
“You have two sets of problems: a generation that has no clue and hasn’t seen death,” he said, “and a generation that is older that is completely bombarded.”
“I think there's a whole negotiation morphing period going on right now as we get embedded in these technologies more and more,” Halkitis continued, referring to HIV prevention medications. “I don't think it just changes overnight.”
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