I’d Rather Use A Rubber Than Get An STI

Why I won’t fuck without a condom even though I’m using PrEP

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His firm, hairy chest rises and falls in quick succession, his breathing is hard. I can see the sweat dripping from his arms as I run my hands across his stomach, searching for the sweet spot that drives him wild. I bite his left nipple gently enough to pull a moan from his mouth while his hands grip my ass. I lean to his ear and ask if he has a rubber, nibbling his earlobe to tease. “Don’t worry I’m on PrEP,” he says. I repeat my question, a little more seriously and again he says he is on the medication designed to help prevent the spread of HIV. In a second I’m flaccid and looking for my clothes — PrEP is no excuse to fuck bareback, even though I am in the process of starting the treatment myself.

Since the release of pre-exposure prophylaxis, PrEP, in July of 2012, there has been much controversy about the treatment and whether or not it increases the likelihood of unprotected sex, especially in the gay community.

My decision to begin the treatment was one I made back before the treatment was approved by the Food and Drug Administration, FDA. Because I am a sexually active gay man, I believe it is imperative to my health that I take any and all preventative measures to protect myself not only from HIV, but the slew of other STI’s floating around.

According to the Centers for Disease Control, CDC, the rate of HIV among men who have sex with men, MSM, had risen to 67 percent of all new infections in 2014 compared to 55 percent in 2013. Although new HIV infections between 2005–2014 went down 19 percent, the rate among MSM increased by six percent.

The CDC also found “Gay and bisexual men accounted for 83 [percent] (29,418) of the estimated new HIV diagnoses among all males aged 13 and older…” What is more frightening is that MSM between 13 to 24 accounted for 92 percent of new infections among all men in their age groups.

These numbers are frightening on their own, but what is more terrifying is the rate of STIs among men who have sex with men. Among men between the age of 15 and those over 40 the number of Chlamydia infections rose from 54,241 in 2013 to 60,230 in 2014; Gonorrhea rose from 23,664 in 2013 to 29,099 in 2014. These figures do not distinguish MSM from strictly heterosexual men.

So what about MSM? According to a study published in the medical journal, AIDS, “Incidence rate ratios showed that MSM using PrEP were 25.3 times more likely to acquire a Neisseria gonorrhoeae infection, 11.2 times more likely to acquire aChlamydia trachomatis infection, and 44.6 times more likely to acquire a syphilis infection versus MSM not using PrEP.”

With that information handy, it seems only obvious that one would use condoms in conjunction with PrEP. That isn’t the case. According to Jose De La Terra, the whole point of going on PrEP was to be able to bareback without the fear of contracting HIV.

“I’ve been fucking since I was 17 and I’m 32 now, and in all those years I can count on a hand how many times I didn’t use a condom — before PrEP. As soon as I could, I got on the treatment to be able to not worry about getting HIV. I know there are other things out there, but there’s always a cure for that. There isn’t one for HIV.”

De La Terra isn’t totally correct on that. According to STD-gov.org, there are three main types of sexually transmitted infections that are incurable. Next to HIV/AIDS, hepatitis B, C, and D do not have a cure and neither does the Human Papillomavirus, HPV or more commonly known as genital warts.

As a personal choice and as someone who has had the clap, I would rather error on the side of caution than risk getting another infection like that. Not only that, I want to ensure that the guy I’m sleeping with is protected from something I may not know I’ve contracted.

Knowing whether I have an STD however is easier with PrEP. Part of the treatment requires patients to get an STD screening every three months for the first year and every six months after that. This may also be why PrEP users see higher rates of infection compared to those who are not using the treatment.

While I get dressed and prepare to leave my partner grabs my arm and brings me back into his arms. “Is it really that big of a deal? It’s just the clap, there’s a cure,” he says. I can only roll my eyes as I break from his embrace, he may not have gotten laid but with a mentality like that he’s already fucked.