Meet a guy testing controversial new drugs that could stop you getting HIV

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Writing for PinkNews, Robbie Dean answers questions about PrEP, a new drug regime that could stop you getting HIV.

So you’re part of the Truvada PrEP trial in the UK – how did you get onto it, and what convinced you to be part of the trial?

I have made a living working around gay sex and the gay press. I have also gone to a lot of parties and, like many gay men, used chems for sex. They breakdown the inhibitions and heighten the sexual mood.

The availability of PrEP in the UK as part of the PROUD Trial has enormous potential to reshape prevention for the future and I wanted to be a part of doing something in the ‘real world’.

In the UK The PROUD Trial has recruited 545 HIV negative volunteers as part of a two year study to evaluate the effectiveness, safety, resistance and adherence to the use of Truvada taken as Pre-Exposre Prophylaxis and any impact on sexual behaviour.

Leading medical professionals including the World Health Organisation have agreed confidence in Truvada administered as PrEP. Many health professionals claim over 90% effectiveness stopping HIV transmissions between gay men but only if taken on a daily basis.

If the PROUD trial proves successful it could be rolled out by future governments saving huge amounts of money currently spent on treatment and more importantly saving lives. Given the upcoming elections, why not ask your local candidates about their opinions on PrEP?

Has PrEP changed the way you approach sex? 

It has given me confidence exploring the sex I want. Science is changing – and so should we. I take my medication daily, just one pill, so I have every confidence that PrEP can be successful.

As part of The PROUD Trial I have regular sexual health MOTs. I understand there is a concern in respect of transmissions of other STIs as a result of sex without condoms but I have an unprecedented relationship with my sexual health team as a result of the trial.

What do you make of the term ‘#TruvadaWhore’?

Look, here is the truth: not all gay men use condoms all of the time. Many prefer not to use condoms at all. There are many reasons why not, some complex, some at the core very simple – two men in a civil partnership, perhaps.

Personally I have known Grindr shags make a swift exit when learning of my PrEP medication (but would have been well up for BB otherwise!) whilst even my own doctor concluded I must be HIV positive if I was on the PROUD Trial – totally missing the point.  If PrEP can help gay men negotiate the gay sex they want, and more of it, then good for them. Gay men should feel good about the sex they want.

Any stigma surrounding PrEP could stop gay men from choosing a reduction method at all. That can cost a huge amount of money, suffering and lives.

What would you say to those who suggest that PrEP would encourage gay men to take a more promiscuous approach to sex?

Gay men on the UK trial are asked to keep a summary of their sexual behaviour so we will one day know the answer to this.  Previous trials overseas have showed little evidence.

Gay men have long been renowned as promiscuous, as have many straight men (though often justified as ‘affairs’). Gay men tend to be more open about the sex they are having.  Personally I feel protected from HIV transmission using Truvada as PrEP.

There are environments such as gay sex parties, saunas, Apps etc where it is easily possible to have sex with multiple people within a short period of time. But from personal observation sex without condoms in has been on the rise for some time now. It is not PrEP that is accountable for this.

Do you think there could be an issue with some men saying they are on PrEP when they are not? 

“I’m HIV negative” (last time I tested), “Of course I am wearing a condom”, “Did I not mention I am in a relationship”, “My viral load is undetectable”. How many times have we taken messages like this for granted? Sexual choices are yours to negotiate and there are always risks.

Some have compared attitudes to Truvada to birth control 50 years ago (suggestions that it should only be given to serodiscordant, monogamous couples, not single gay men). What do you say to that? 

Cruising, casual sex, chill-outs, threesomes and moresomes are not a new thing.  Neither is guys choosing not to use condoms during sex for various different reasons.  These are some of the people most at risk. Providing an alternative solution for all gay men who are not using condoms is a key priority.

Is it the case that Truvada as PrEP will replace condoms? Does the rolling-out of the drug need to be bolstered by inclusive, consistent sex education?

Some health professionals believe that if all gay men used either PrEP or condoms we could virtually eradicative HIV within a few decades.  Few are actually saying stop using condoms however, advocating a joint approach instead.

If you are comfortable with condoms for sex, stay with condoms. If not there are alternatives. The GMFA website is a good source of information featuring other techniques such as sero-sorting and role negotiation.

I believe that reaching younger gay men through mandatory sex education in schools and colleges would help protect a vulnerable generation and lead to good practice for the future.  I am particularly inspired by testing events at bars such as G-A-Y and other places where where young gay guys actually hang out. The gay media in general could be used more creatively including audience segmentation and better use of social media and other websites.

It’s time for further investment in a multi-tiered approach that gay men from all walks of life identify with including the gay sex party scene, young gay men and the increasing amount of gay guys injecting drugs such as methadrone in order to get high.

Ultimately all media should clearly tell how easy it is to get a free HIV test: More than 7,000 gay men in the UK have HIV and don’t know about it. 80% of new HIV transmissions are through someone who didn’t know they actually had the virus.

Robbie Dean is a gay media specialist and tweets @robbiejohndean