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Sex without shame - The possibilities PrEP offers me and our community

Sex without shame The possibilities PrEP offers me and our community

Harry Dodd, a 25 year-old PROUD Trial participant, discuss PrEP

On Christmas Eve 2012, I was getting off the train in Liverpool from London to visit my family. The night before I’d had sex with a guy that I’d been seeing - and a guy that I trusted - for a few weeks. The only difference about that previous night was that, for the first time, we didn’t use a condom. As I approached the station he messaged me asking about my status. I replied and told him I was negative in response to which he said I should go to A&E - he was positive, recently diagnosed with a high viral load.

I was born ten years after the outbreak of HIV and wasn’t sexually active until 16 years later. Still, the virus haunted my upbringing. Knowing I was gay, I was raised in the lingering shadow of this fear. HIV is still here, still real - and I was petrified.

This example is perhaps the most definite close call I could muster – he was good enough to tell me. But it is important to reflect on all the other times that I assumed the odds were in my favour, judged books by their covers, and never asked important questions until it was too late anyway; fear haunted sex and relationships, it eroded trust and, to a large extent, perpetuated divisions within my mind. Many people say that the solution to this is just to wear a condom – and perhaps that’s right. But the reality remains that people don’t – for whatever reason – and it just takes one time, that one slip up, to change your life forever.

I found writing about this part of my story – the fear and anxiety - one of the hardest parts to recall – and that says a lot in its own right - because for in the region of two and a half years now I have been able to shake off the sense of fear and guilt that followed any sexual encounter without a condom. I have been released from those divisions, and, as a consequence, allowed myself to settle into a relationship where those fears and anxieties are removed through my own proactive prevention measures, measures I know I comply with.

The summer after that Christmas, I went to the clinic for a regular check-up. On reviewing my notes - and on admitting that I’d had unprotected sex a few times in the past few months - the doctor asked if I would be interested in taking part in a research trial. I spoke to the nurse and raised my concerns over potential side-effects - I’d had a rough ride on PEP and was hesitant to voluntarily repeat that. The nurse assured me that this would be different and I agreed, somewhat blasé, to give it a go.

It took me some months to feel truly comfortable with that decision. The stigma of HIV feels all pervading; admitting the risks I was taking and agreeing to a fairly intensive preventative trial was almost conceding to the inevitability of a diagnosis. But my confidence grew, and that embarrassment soon turned to pride, especially when favourable results started to come through, and it became increasingly apparent that these results could prove ground breaking.

That growing sense of pride, however, wasn’t with the same response by everyone; I found resistance from even some of my closest gay friends, who rather than showing support made their disapproving opinions quite apparent. If I were taking on a trial seeking to prevent Alzheimer's, or any other condition, I wonder whether I would have had such a difficult time – both within myself and when ‘coming out’ to other’s.  Where this stems from I’m not quite sure. Our united cause is surely in favour of at least giving this drug a proper trial – whether or not you think it’s for you.

Nonetheless my confidence of the drug’s effectiveness grew and my attitudes towards sex and relationships started to change. I slept with people despite the knowledge they were positive. People I liked, people that I had gotten to know that previously I would have sorrowfully turned away from, condom or not - if they were brave enough to have told me. And the word to sum this mind change up is ‘liberation’. I don’t mean sexual liberation - important though that is.  The liberation from the ‘risk and danger’ element of sex and relationships that always preciously hung over me; the liberation of mind - not worrying, and being able to date people and see people irrespective of their status. The liberation to be with someone you like without fear.

Let me give you a potential snapshot of a fearless future. About 18 months ago now, I met someone who I later discovered was on the PROUD study, too. I cannot express the reassuring comfort that knowledge delivered; two consenting adults both empowered to take control over our sexual health in ways never previously possible. That experience struck me how intertwined my fears and anxiety over HIV and AIDS were with my apparent inability to form relationships, develop trust and think long term. Previously, HIV was a ‘when’, not ‘if’. How can someone form a life plan with another person when that mentality lingers? This has haunted my childhood, plagued my judgement – and here, suddenly, it struck me; that that fear had been lifted.

We look back at the contraceptive pill – and bear with me here – as the breakthrough which lifted women from sexual oppression, fuelled the social revolution of the 1960s and empowered women for the first time to take ownership of their sex lives without fear, shame or unwanted consequences. So then I am baffled at the evident resistance to this medical triumph.

Just as the pill brought sexual liberation not just to isolated, promiscuous women, but rather peace of mind to countless mothers, professionals and the womankind at large, so too can PrEP heal a community for the first time in three decades torn apart by HIV. Only then, united, can we begin to truly tackle stigma, fictions and myths with any real effect.

There are five people a day diagnosed with HIV in London alone – this problem isn’t getting any better; it’s getting worse. We’ve been well educated about condom use for decades; our knowledge and understanding of HIV has grown immensely, but there are still people falling through the net. Do we want to bury our heads in the sand and ignore them? Or are we, as a community, as a society, brave enough to come together and admit that there is still a long way to go? I don’t profess that this is the solution to eradicating HIV.  However, given the opportunity of another weapon in our arsenal against this growing disease why would we not choose to take that?

The great challenge of the generations before us was to maximise life expectancy and quality of those who were HIV positive. Great things were done, but there is a long way to go. The great challenge for this generation, I truly believe, is prevention – and PrEP can play a huge part in that.

Harry DoddHarry Dodd, 25, is a PROUD Trail participant

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