The first thing I did this morning was take my PrEP. PrEP stands for pre-exposure prophylactic. It's a combination of drugs you can take when you are HIV-negative that will prevent you from getting the disease. For queer people like me — or anyone who is at risk — PrEP has changed not just our sex lives, but our personal lives, our culture, and the way we relate to the world around us. For the first time, we can live without the fear of HIV/AIDS. For me, that has been a profound transformation.
America first learned of a spreading, incurable, and fatal new disease in 1981; it would later be identified as the human immunodeficiency virus, or HIV — the virus that causes AIDS. It devastated millions of people as it moved around the globe, aided by indifference, poverty, superstition, and bigotry. In the United States, it primarily affected gay men. Three hundred and sixty-two thousand died between 1981 and 1996. AIDS activist and playwright Larry Kramer called it a holocaust.
I was a 1980s preteen when I first became aware of it. I wasn't out then, even to myself, but I knew this had something to do with me, something that was going to make life much harder and definitely scarier. AIDS was a constant presence in my life before I could even see an R-rated movie unattended. But I did see Common Threads, the documentary about the AIDS quilt, and cried my eyes out for all the people I didn't know, for strangers I had so much in common with.
I moved to New York from Santa Cruz in the early '90s to attend college. Everything was new, even old things like subways and dive bars. The scene was exciting, but tempered by the reality of HIV/AIDS. I met and saw the artists and activists who would shape my life, many of whom were making work related to the disease: Diamanda Galás's Plague Mass, Todd Haynes's Poison, John Kelly and the work of the Visual Aids Artists Caucus. These performances were tinged with rage at the system for ignoring us, and there was power and grace emanating from a community under siege. It was a time of rapid change in the gay-rights movement and it seemed like the arts and queer rights were so connected.
At the same time, there was a collective weariness. Friends, and friends of friends, and their friends too, were testing positive. Some were dying. Grief was omnipresent. Despite the work of activists and health-care providers, there remained an unfair stigma associated with one's HIV status. Princess Diana was considered brave for even hugging or shaking hands with an AIDS patient.
Once, before he died, my friend Douglas asked me to button his coat because he was too weak.
A year later the medicine came.
Highly Active Anti-Retroviral Therapy (or HAART), also known as the "AIDS cocktail," became available in 1996 and turned what was once an almost certain death sentence into a manageable, chronic condition. A friend of mine tested positive and I was overcome, until everyone reminded me: "It's different now." A cure seemed as far away as ever, but this treatment gave hope to so many gay men, queer-identified individuals, and trans women. Today over a million people are living with the virus well into old age.
But I was born prone to anxiety and the anxiety remained, even though HIV was no longer fatal. Well into 2001 and 2002 I had a fear of contracting HIV that went far beyond the actual risk, and I often suffered from intense post-sex panics, no matter how many safe practices had been involved. I was superstitious of getting tested, worried I'd receive a false positive, as a good friend of mine did once. (I got tested anyway, despite my fears.) And the stigma, like my anxiety, remained. All you had to do was open Grindr to see the disturbing use of "clean" to indicate an HIV-negative status, as though our brothers and sisters who are positive were somehow "unclean."
And then in 2012 came Truvada, a combination of two antiretroviral medications that, if taken daily by an HIV-negative person, makes it almost impossible for HIV to take hold in the body — hence the name PrEP. Initially, Truvada was slow to catch on. But even though its use is far below what experts consider optimal, it's already changing the way we relate to each other. It fundamentally alters the dynamic between positive and negative sex partners. On many dating apps now, guys will state whether they are on PrEP or not.