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Sex Without Fear

The new pill that could revolutionize gay life is reawakening old arguments.

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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.


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