Tuesday, August 9, 2016

Something to Consider

Spectrum Health called me last week to ask whether I'd be interested in being involved in a PrEP program they are running this fall trialling some new PrEP medications. I don't know any of the details, but I have considered (if I was eligible and could get it covered under my insurance) the possibility that I might be a good candidate for PrEP regimens. The trial program runs 6-8 weeks.

As you know, Mr P and I are in an open relationship and we prefer to have our regular men and boys we have sex with. There are some one-offs but generally we know the guys we fuck quite well and we generally use protection based on our household rules of who in the crew we can fuck bare and then everyone else, who we fuck with protection.

I never have thought of myself as super high-risk for HIV transmission based on our rules, but then as I've been topping more and more I've been seeing how much bareback sex has in fact been going on out there. I'm guilty of being a bare top in the past, but there is no shortage of bottoms that demand bareback. It's pretty strange as a bottom who generally refuses to get fucked without protection.

This kind of came to a head in my experiences about this on Sunday. I was chatting with a local guy on Scruff about getting together to play - we had a lot of similar interests, we both like fisting, we both have slings. I thought we had sealed the deal, then - out of the blue - he asks: "Do you fuck bare?", to which I responded, "generally, no. I have house rules I have to follow which means if you and I fuck, it's going to be with condoms".  Then I jokingly added, "I hope that isn't a deal breaker", to which he responded, "actually it kinda is."

I thought, 'holy fuck!' I kinda found it hard to believe....I asked him if he was on PrEP, to which he replied that he was. I'm seeing this as kind of a trend.....I know several guys on PrEP treatments who now fuck bare and are fierce defenders of being able to do so.

I think that is all fine and good, and from what I've gotten from discussions with these guys is that they do not consider STIs a big consideration in their decision to fuck bare (this is a generalization based on a limited number of conversations, of course), but would you actually refuse a fuck because the topping guy wants to wrap up? Is this such a moral imperative for you that you - AS THE BOTTOM - wouldn't take a fuck from a top with a condom on? I don't understand the logic. In addition, is no one upset about STIs anymore? Like, sure, HIV is bad and I appreciate not having to worry about that anymore if on PrEP, but aren't STIs a concern?

They are for me.....first of all, they are super inconvenient, and I typically end up embroiled in STI scares that come just before big events or long weekends, which basically fucks you for a big event or something you were gunned to get laid at. Secondly, you are NOT taking care of your sexual partners with such a nonchalant attitude to STIs. I feel that not spreading STIs is part of responsible sexual health, and the attitude that STIs are 'no big thing' is irresponsible. I don't want STIs, I don't want your STIs, I feel I have failed if I've been complicit in spreading an STI (I feel guilty even if I wasn't complicit yet still passed something on....), so how is my desire not to be out of commission for a week or two overridden by your desire to be fucked bare? This concern might some from the types and severities of STIs I've had in the past. I have only had an STI twice and once was neurosyphilis that I had to go on IV antibiotics for four weeks to resolve (and consequently had to come out to my parent due to it...not a great period in my life). STIs aren't something to take lightly. Which leads me to thirdly, and most likely paranoid, is the possibility of superbugs or superSTIs developing due to what I consider careless(?) sexual practices, spreading of virulent strains of STIs and the evolution of even stronger strains due to poor diagnosis, prevention, and treatment. I don't think 'careless' is the word I want to use, but....it conveys the frustration I have with this issue.

Man oh man, the whole conversation with this guy sort of put me off PrEP. I thought it might be a good idea, but now all I can think about is becoming a big bareback slut and spreading STIs around once I'm on PrEP. This makes me kinda sad - of course I can use PrEP to whatever means and ends I want, but these guys that are so focused on barebacking now that the concern of contracting HIV is not what is concerning me anymore. There is more going on in the world than just HIV avoidance.

Anyways, this is my moral dilemma for the day. All of this is very regrettable.


Jim Drew said...

One thing to realize about STIs is that they are largely all treatable/curable. It may be a pain in the ass (ha!) to do so, but the option is there.

Another thing to realize it that most of them don't require a bare cock in the ass. They can be got from rimming. From fingering. From sucking cock. From kissing. And in some cases, from just skin-to-skin contact. Requiring rubbers removes a major vector, but the others have always been there, just never mentioned much because HIV HIV HIV HIV HIV!!!!!

One perk of PrEP is that guys are required to get a periodic liver enzymes (I think that's it) test, which makes it easy to get STI tests at the same time. Which means they are getting tested more frequently than before, so anything there is being caught and treated sooner -- less severe and less pass on.

On the downside, we've known for decades that guys would claim a latex allergy to fuck bare. And they would claim to be negative fuck bare. And they would claim to be Undetectable to fuck bare. So we know there are guys not actually on PrEP who are saying they are in order to assure fucking bare.

Also, there are HIV strains resistant to Truvada, which PrEP does not protect against. I have one friend who seroconverted while on PrEP as a result of that.

In the end (ha!), though, I have come to realize that those of us in the cohort who came of age in the late 80s to the mid 90s have had a huge Fear Of Dick drummed into us — "If you fuck even once without a rubber, you could get AIDS and DIE!!!!!" We don't really realize the level of trauma, the huge invisible burden that has put on us until options like PrEP suddenly remove it. "Oh, wow. I can fuck. The fear and guilt are (mostly) gone!"

The guys who insist on "bare or nothing", some of them are reveling in that removal of guilt. Playing with rubbers again, to some of them it signifies a return of the guilt, a capitulation to the dominant paradigm which says equates Sex with Death.

Most of them, though, know that there are lots of guys out there who will fuck bare if they ask, so if you won't, then fuck off, someone who will is just down the grid on Scruff.

MB said...

Yup. All of this yes.