Smudge sticks and salt lamps aside, I stick by the scientific method. So far, I haven't been swayed by the alternatives: Magick? G-d? Knee-jerk cynicism? Ultimately, what option do we really have? Each one of us places a firm foot forward in the march of human history, whether we trust our best collective guess or not. Logic lead me forward.
As some of you might know, my brief foray into the world of sex-advice came to a close recently. Blogs change hands and companies pursue different profit strategies. My relationship with Manhunt ended happily, much as it proceeded throughout the course of our professional relationship together. I deeply appreciated the degree of creative freedom Manhunt allowed me to exercise. They never once interfered with suggestions, proposed I censor answers or asked that I curtail my aesthetic choices, except once. . . for one specific set of videos. . .
Two years ago this July, the FDA approved a pharmaceutical solution to the problem of HIV transmission. Truvada, a single pill composed of two seperate drugs already used to suppress the virus in HIV positive patients, could now be prescribed as a pre-exposure prophylaxis (PreP) for HIV negative individuals-- for all intents and purposes, a condom in pill form.
Last January, Manhunt asked if I'd like to interview one of the principle research scientist working with Truvada and create three separate informational videos conveying my understanding to viewers. Like many who first hear about Truvada (or any new pharmaceutical product for that matter) I turned instinctively to skepticism to guide inquiry further. A pill for what??? Really!? That said, I tend to trust peer-reviewed medical research. I'm plenty paranoid about the government's relationships with big business, but I tend to support the rigorous standards of the United States Food and Drug Administration and its hard working employees.
Skepticism closely guarding my back pocket, I'd happily trust the first FDA approved HIV vaccine too. Truvada isn't a vaccine, but so far it's the closest thing we've got.
After cautious consultation with my physician and a full-panel of blood tests, I popped my first pill more than a year ago, both to protect myself and to relay my experience with future viewers. Thanks to a drug rebate courtesy of Gilead, Truvada's manufacturer, I don't pay a dime.
I submitted my videos and waited. . . . waited. . . and waited some more. . . .
Manhunt paid me promptly but never posted any of the three well-researched videos I created. Why? I can't say for certain, but I came to understand that Manhunt had already encountered a good deal of pushback simply for considering the project. I, in turn, received the only bit of kindly editorial censorship I would ever encounter while working for Manhunt: never mention Truvada again.
"He sent the prescription to my pharmacy. The email notifying me that my prescription was ready informed me that this would cost me $1,389.99. "Welp," I thought. "There goes that idea. I don't need it that badly." Not that I could afford it if I did. Gawker hardly pays me a gay porn salary."
I can assure Rich that no gay porn performer earns "salary". What we do make hardly allows us to splurge on unnecessary pharmaceuticals. Sadly, no performers receive insurance through porn studios. I most certainly earn less than your average poorly-paid journalist. My generous insurance policy comes courtesy of BSD Minister of Propaganda Karl Marxxx. That said, a group insurance plan for sex workers of all stripes (pie in the sky perhaps, but worth imagining) would go a long way to help protect the health of performers.
I also can't claim any of the negative side effects Rich mentions in his article. I continue to take Truvada every day. I get my kidneys and blood tested every three months and haven't experienced a single complication.
Some statistics are worth restating if you don't feel compelled to read Rich's article fully:
Taken as prescribed, once a day, nearly all studies suggest a rate of protection against HIV infection somewhere in the range of 90-99%. Unfortunately, in some studies, nearly 50% of recipients failed to take the drug consistently, leading to a higher likelihood of potential infection and thereby statistically lowering the effective rate of protection cited. Patients must take Truvada once a day, every day, for the drug to effectively protect against infection. For comparison, studies show that condoms, especially when used in anal intercourse, only protect users at a rate as high as 76%.
Studies of HIV negative gay men using Truvada have also failed to reveal any statistical increase in the rate of transmission of other STDs, like syphilis, which can spread easily even with condoms. Many patients report having less sex because of "slut-shaming" suspicion surrounding use of the drug.
For additional information, I highly recommend the following:
A study measuring the effective rate of protection for users of Truvada
"Why is No One On the First Treatment for H.I.V.?" by Christopher Glazer for the New Yorker
"There Is a Daily Pill That Prevents HIV. Gay Men Should Take It." By Mark Joseph Stern for Slate