By Mikkel Hyldebrandt

With the introduction of PrEP (pre-exposure prophylaxis), the way we think and do sex has changed dramatically – and it has vastly impacted the health of gay men positively. Damon L. Jacobs, Licensed Marriage and Family Therapist, started a global Facebook group called “PrEP Facts: Rethinking HIV Prevention and Sex” after he began using PrEP in 2011, and Peach spoke to him about how the blue pill is reshaping sex and lifting fears and stigmas surrounding gay sex.

For those who don’t know, what does it mean to be on PrEP?

PrEP is a pill that prevents HIV. Similar to birth control pills, it can be used to put an individual in complete control of their sexual health and not rely on a sexual partner to protect them from HIV. The medical term for “PrEP” is pre-exposure prophylaxis. But for me and hundreds of thousands of others in the world it has come to mean Proactive, Responsible, and Empowered Pleasure.

How long has PrEP been available?

PrEP was first FDA approved in July, 2012 for adults, then May, 2018 for adolescents.

What side effects have occurred since introducing PrEP?

Side effects are uncommon and rare. It is estimated that about 1 in 200 people taking PrEP may see some renal (kidney) changes. That is why it is expected that people using PrEP will have their blood drawn and kidneys checked at least twice a year. So far, there are no reports of anyone experiencing irreversible kidney changes while using PrEP.

In your opinion, how has PrEP reshaped the way we think about sex and prevention?

For the past three decades the only HIV prevention strategy for anal sex was condoms. Fear of AIDS and death shaped the narrative of HIV prevention, rarely ever acknowledging the value of pleasure and semen exchange between two or more adults. PrEP has completely shifted the idea that fear and punishment must be the driving force in prevention messaging, and allowed room to discuss playful, respectful, sexually meaningful ways of communicating about health and wellness.

What are some of the most common misconceptions about PrEP?

There are 5 major misconceptions that have prevented greater uptake in the U.S.:

(1) That using PrEP will result in kidney or liver damage. Truth: Daily use of PrEP has been measured as safe as daily aspirin.

(2) That using PrEP puts people at greater risk of getting more STIs. Truth: Using PrEP means people are going to get tested more frequently than they would otherwise, therefore treated and documented more conistently.

(3) That PrEP is unaffordable. Truth: Most people in the U.S. pay close to zero for PrEP through the Advancing Access program (1-800-226-2056).

(4) That PrEP is only “up to 92%” effective. Truth: The CDC states that PrEP is more than 99% effective when taken as prescribed.

(5) PrEP makes you more promiscuous. Truth: PrEP allows you to be honest about the sex you are already having, and to be truthful about the kind of sex you want to have.

Are there any added advantages that people are generally unaware of?

PrEP is changing the experience of associating anal sex with punishment and death. Many of us of a certain age (in our 40s and upward) came out in a time when intimacy and pleasure were automatically associated with trauma from the AIDS crisis. Condom use had always been inconsistent, but shame, stigma, and homophobia prevented gay men from talking openly and honestly about their enjoyment of condomless sex. Now, thanks to tools such as PrEP, and U=U (undetectable = untransmittable), we can engage in sexual connections with pride, clarity, respect, and open communication.

In your opinion, who should be on PrEP?

I don’t believe in the word “should” in healthcare or wellness. But I do believe PrEP would add great value to any person at risk of acquiring HIV, or anyone who wants to do something that could put them at risk of acquiring HIV. It is especially advantageous for people who bottom to be in full control of their sexual health and protection.

How do you get started on PrEP?

You can go to the national PrEP Directory (preplocator.org) to search for a PrEP specialist near you based on zip code.

Anything you’d like to add?

It is long past time for people to prioritize facts over fears; science over stigma; data over dogma. We have a real opportunity now to end the HIV epidemic in the next decade – let’s do this!

Learn more at facebook.com/groups/PrEPFacts.