Looking for PrEP: Part 4


Looking for PrEP: Part 4

By: Alex Aviance, Guest Blogger

Disclaimer: The views expressed by guest bloggers are solely theirs and do not necessarily reflect that of Dosti, Snehithan, Lassi, or any programs and services of ASAAP. 

The truth is my family doctor and I have a good relationship. She’s known me since I was at least 9-years-old and is privy to some of the most intimate and personal details of my life. She’s been given a front row seat to my sexual escapades and is somehow always surprised when I don’t gag when I get my throat swabbed.

Still it’s strange not to mention awkward to have this conversation because of the unspoken implication that once I’m on PrEP I’ll be the courtesy bottom at every circuit party from here to San Francisco. I had brought up the subject of PrEP on an unrelated visit before, and her response was sort of what I expected: I’d be better off consulting an infectious disease specialist. Education amongst doctors still seems to be a huge bump on the road to PrEP, but it wasn’t a “no” so much as it was a “go ask someone else.”

Let me contextualize a bit. My doctor’s office is out in Scarborough, located next to a Caribbean restaurant, in a shady strip mall. The nearest guy on Grindr is about 4.5 miles away, and when I made my appointment to see my doctor again I had to repeat to the receptionist that I needed a prescription for PrEP about 4 times and she still had no clue what I was talking about. The Gay Village this place isn’t. After being told I was now on a waitlist for 8 weeks this was unfortunately my best (and fastest) shot.

At our appointment despite going over it in my head how I thought the conversation would play out she threw a barrage of verbal curve balls I could only hem and haw my way through. Why was I having unprotected sex? Why was negotiating condom use so hard for me? Why didn’t I want to have safe sex? She wasn’t holding back, and the truth was I didn’t feel comfortable, nor was I sure I had the time to explain the various intricacies and nuances of the power dynamics between tops and bottoms in the age of Grindr through a lens I thought she might understand.

I didn’t have answers for all of her questions, but I knew why I wanted to be on PrEP. I want that added layer of protection. I’m working through my own stuff, I’m starting a new career, and I’m doing my best to navigate the queer dating world, but it’s not enough. I’ve had guys take the condom off without telling me, I’ve had condoms give out to the friction from an overly aggressive fuck, and if I’m being completely honest I’ve also been so caught up in the moment the condom never left the nightstand. These are the realities of my current sex life.

I do use condoms; I do everything they tell you on the posters in the clinics, but is sex ever “safe”? Anyone having safe sex is doing it wrong I’ve been told because sex is inherently messy and prone to unforeseen circumstances. Why is it that PrEP isn’t considered part of my safe sex strategy?

She seemed satisfied with my response, and expressed genuine concern for my well-being. I suddenly remembered I had printed the CDC guidelines for prescribing PrEP to bring with me. I would need some blood work to confirm that I was HIV negative and that I was otherwise healthy enough to take Truvada on a daily basis.

Thankfully that was exactly what she needed to see, and she agreed to write the prescription for me. I could have my little blue pill, but not without some parting words of warning: To seriously reflect on why I have a hard time negotiating condom use and to consider what it might mean to become and live in this world as an HIV positive gay man.

And I do, every single day.


Alex Aviance is a young, queer man who lives and blogs in Toronto, Ontario. His interests include theoretical physics, cooking, World of Warcraft, and Ru Paul’s Drag race. Alex currently holds a B.A. in Journalism from Ryerson University and has plans to return to school to study social work. He hopes to pursue a career working in the field of queer men’s sexual health. His idols include Naomi Campbell, Anna Nicole Smith and Tammy Faye Bakker. You can often find him consuming far too many carbohydrates, destroying the patriarchy, and very likely engaging in a Twitter war @AlexAviance.