New York Times: Won't Someone Please Think of the Condoms?!?
LatestToday, there’s more than one way to have penetrative sex in which the risk of HIV transmission is dramatically reduced—using PrEP and condoms are two. PrEP, for the uninitiated, stands for pre-exposure prophylaxis and describes an antiretroviral regimen that HIV negative people can take to protect themselves from contracting HIV up to 99 percent (of the hundreds of thousands of people on PrEP, there are four reported cases of people who adhered to the regimen daily and yet still contracted the disease).
PrEP, which for now in the U.S. is available only via Gilead’s combo drug Truvada, is particularly popular among gay men. Because of the way AIDS ravaged the overall population of sexually active gay men in the ’80s and ’90s, and continues to disproportionally affect certain groups within that population like black and Latino men who have sex with men, the idea that people can take a pill that effectively eliminates the risk of HIV is scary to people. Since the FDA approved Truvada as PrEP in 2012, we’ve been hearing a lot of Chicken Little-type arguments about the advent of a new dawn of condomless sex within gay men (instead of the sky falling, a chief concern is an as-yet-unknown microbe rising from out of nowhere to start killing people left and right). We’ve been hearing arguments about why gay men, who spent decades terrified of sex, should stay terrified of sex. It can be very hard to untangle reason from sex negativity, the “ick” factor of gay sex (that even affects so many gay men) with a general concern for one’s community.
So what to do with Patrick William Kelly’s New York Times op-ed “The End of Safe Gay Sex?,” whose headline is built on the assumption that the only kind of safe sex is that which is had with condoms, and whose argument is based on the idea that PrEP is doing a disservice the population whose lives it is protecting. Besides ignoring it outright—a wonderful strategy for dealing with whatever serving of bullshit the world wants to give you on any given morning (literally, go meditate, direct your thoughts elsewhere, live your best life in your head)—I’m inclined to go through and respond to some of its assertions. I don’t think the answer to the real problem of rising STIs is discouraging PrEP, and I don’t think any amount of condom propaganda is going to make people want to use condoms (because… look around). I certainly don’t think at anyone’s next raw orgy someone’s going to announce, “Hold up, because according to Patrick William Kelly…”. I think a piece like this, like so many pieces these days, lives in its own bubble of self-righteousness serving only the virtue of its writer, whose own attitudes toward sex and what an actual condom feels like against his skin are conspicuously missing from his work. That’s to say that this piece about condoms is worth poking some holes in.
Kelly writes:
June is Pride Month, a ripe time to reflect on one of the most startling facts about our sexual culture today: Condom use is all but disappearing among large numbers of gay men.
I guess this is startling if you’re a condom manufacturer, or if you somehow believe that condoms are magic and have solved all of the world’s sexual health problems. Spoiler alert: They haven’t. STIs like syphilis have been on the rise in some metropolitan areas (like New York) since the early aughts and HIV has not gone away. In fact, instances of new infections after the 1996 approval of protease inhibitors have been fairly stable amongst men who have sex with men—this was true more than a decade later, as Advert reports that for that population in the U.S., they hovered at about 26,000 per year between 2010 and 2014. Clearly, to fight the epidemic, something else was needed.