PrEP and Slut Shaming in the Gay Community

HIV/AIDS has been a major pandemic in society today – especially in the gay community. Over the years, there have been many advancements in the treatment and prevention of HIV.

One of the newest forms of prevention is called PrEP or pre-exposure prophylaxis. This is a drug combination used to greatly reduce the changes of contracting HIV when taken daily. It is a combination of two drugs – tenofovir and emtricitabine.

The brand name is Truvada and originally was not listed on the Ontario Health Ministry’s drug formulary of publicly covered drugs. This meant that the full cost was at the expense of the consumer. The cost of Truvada was over $1000 per month. This put many at the greatest risk out of the market.

Recently, Ontario added PrEP to its list of covered drugs. This does not mean that PrEP is free, but rather that drug programs like Trillium would cover that cost. Trillium isn’t a free drug program but every Ontario citizen is eligible. Individuals pay up to 4% of their net income in deductibles. This means that PrEP is now available to lower income individuals who would not likely afford it in the past. The other big advantage of having the Ontario Health Ministry add it to the formulary is that many private drug coverage plans will now cover it as well.

Truvada now comes in a generic form, which has lowered the cost to less than $250 per month – much more manageable even for those not on Trillium or have private insurance.

Regardless of the reduced cost, some argue that the cost of this is still too high to be covered by the Ontario Government. But as John Maxwell, Executive Director of AIDS Committee of Toronto indicated in a recent interview with CBC, the cost of treating an individual with HIV is quite a bit higher than preventing it in the first place. Further, people on PrEP are required to be screened for all STI’s regularly and visit their physician every three months for a check up.

Unfortunately, gay men who decide to take PrEP to help protect themselves from HIV are being shamed for having casual sex (slut shaming). Some might compare this to the shame that women sometimes face for going on birth control. But why is this? Isn’t protecting oneself from a life-long condition a good thing?

For decades, gay men and women have wanted to be seen as equal to heterosexuals. Monogamous relationships are most valued, or at least appear to be in the straight community, and casual sex is a deviation from that norm. Now that a traditional lifestyle is available to gay men and lesbians, any deviation from that is considered just that – deviance.

But given the severity of the situation around HIV/AIDS, should not the fact that people can now protect themselves out weigh all other arguments? Regardless, each of us has to decide for ourselves whether PrEP is right for us.