PrEP ain’t for you…or is it?

 

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Jake: I just wanted to ask a PrEP question.

Greg Owen: www.iwantprepnow.co.uk If it’s not on there I’ve failed. lol

Jake: You didn’t fail but I want an answer in slightly more detail. Event based PrEP. Say someone like me who never has unprotected sex… and I can’t remember the last time I slept with someone who didn’t know their qualified status… I don’t want or need to take PrEP. But say I wanted to try unprotected sex with my boyfriend or someone else on one occasion… so taking PrEP just when I needed it. Is this safe? Is it enough to stay neg. I just read all the options… and you say that taking a pill a day is the safest.

Greg Owen: I have a burden of responsibility to actively promote the safest – ie large study (PROUD) tried and tested daily method. That is why it is positioned like that on the site. The EBD (event based dosing) system has been trialled in France. It is called IPERGAY and yes – it is safe. Official figures suggest 86% reduced risk of HIV infection. However there are variables with this method and so therefore requires a conversation like this so that the PrEP user can be educated properly.

I don’t have capacity to do that with everyone and I really would want to because this method opens up the possibility of risks. I hate the word risk used alongside the word PrEP. The variables are the time between 1st dosing and actual sexual interaction (because studies and tests have found that there is not sufficient HIV protection in the anal tissue until about 8 hours after the 1st dose of PrEP) and you also need to address and fully understand doseage etc and by that I mean the number of pills taken, when and duration. And some people say that the study was based on the minimum amount of time and PrEP required for protection so you could expand on your protection by increasing the time between the 1st dose and sex and the length of time you dose after the sex.

The problem I have with this is that info gets relayed from gay to gay and gets muddled in the middle – a bit like chinese whispers. That makes me uncomfortable when the thing being jeopardised is a person’s HIV negative status.

Jake: I’ll refer other gays to your website – I promise.

Greg Owen: I don’t go into these details on the IWPN site for that reason. At the point when it becomes technical and requires someone of authority to advise on this method we direct our users to their local sexual health clinic to discuss it face to face with a clinician. You are a friend , someone I know personally which is why I am discussing it now.

Back to the point… with event based dosing you don’t have that 100% peace of mind that comes with daily PrEP. So in a way you are running the HIV gauntlet again and that negates one of the key benefits of PrEP. But EBD/IPERGAY is a tried and tested method and the whole point of what I do is to share information and although I don’t personally feel comfortable promoting this method of using PrEP, it still offers protection (up to 86% if used properly) that might very well work for someone and so I put it out there.

I guess it boils down to this – any HIV protection is better than none.

But for you Jake – I don’t think PrEP is perhaps the best thing. It’s people who are already involving themselves in high risk behaviour that need to think about it imminently.

If you like using a condom every time you have sex – stick with it. It’s working for you. 

Don’t muddle it. You have good condom adherence. I’m happy that is the case with you. I would be conflicted in advocating PrEP for you if it were to potentially diminsh your condom use.

Jake: Of course. That’s how I feel. It’s not an issue for me. But I’ve never had unprotected sex with my boyfriend. Just thought it might be nice to try. We both think that we’re negative and of course we both need to get tested. But it would be reassuring for both of us if we also did PrEP.

Greg Owen: I disagree. If that really is the case then you don’t need PrEP. Unless you – or you suspect your boyfriend is having BB sex and not being honest about it. If you aren’t and you trust he isn’t…get tested (full screening) and go for it. You really need to weigh up the landscape on a person (or couple) specific basis. If you don’t trust him and don’t wanna discuss that within your relationship there is another option. You can take PrEP on an EBD/IPERGAY system and just don’t tell him.

PrEP empowers the individual.

Jake: He’s not having BB sex. And he doesn’t lie to me. There’s absolutely no reason for him to lie because we’re totally open. That’s the sole purpose of having an open relationship, so that we don’t have to tell lies.

Greg Owen: If that’s how it works in your open relationship I’m happy for you. That is not the way it works in all open relationships.

Jake: Really?

Greg Owen: Yes – from my personal experience and from what I have ascertained through discussing sex and sexual behaviour with many different types of guys in various different situations.

Jake: Why not?

Greg Owen: I’m generalising now but here we go –

Gay men LIE (some not all)
Gay men take risks (most not all)
Gay men do not tell their boyfriends any of the above (some not all)

Also – I can’t imagine you would be too happy informing your boyfriend that you have had sex with me – a HIV positive guy. Protected or not, undetectable or not. You might not feel 100% comfortable telling him this and I understand that.

Jake: But that’s the structure of my relationship. We said we didn’t want any lies or games. So we’re open from the outset and we’re totally honest. It really works. I don’t understand being open and then lying about being open. Makes no sense.

Greg Owen: I agree Jake but you can only be accountable for yourself. You cannot control or dictate what another person does. Regardless if you have made an agreement or not. If your relationship is structured and works like that I am happy for you both. I’m just saying that some people find certain topics difficult to discuss with their partner. That’s why I mentioned the HIV thing as an example. You in effect removed his choice of introducing HIV into his sex life.

Jake: I totally don’t understand what you’ve just said to me. Introducing HIV to our relationship?

Greg Owen: My point is that some guys wouldn’t sleep with a positive guy and that is totally cool with me. If your boyfriend wouldn’t sleep with a positive guy – if that is just one of his sexual boundries and then you sleep with me as an extra in your open relationship, in effect you introduced HIV or more specifically a HIV positive sexual partner into the mix and I don’t think that’s 100% fair. You took a little bit of his choice away. Of course we are speaking hypothetically here as I don’t know your boyfriend or his opinions or prefernces on HIV positive sexual partners. But I find that when it comes to HIV – even though it’s ME that is positive and not you or your boyfriend, we all still need to mindful and considerate towards each other and that extends to how your boyfriend would feel about you having sex with a positive guy ie me. Regardless if you were at risk or not – which you weren’t because I’m undetectable and we wore condoms. I’m just saying some guys dont like it. And that’s not some strange manifestation of internalised HIV shame on my part. I have none. It’s just being considerate towards other people’s feelings. That’s all. I’m just trying to illustrate a point. Sometimes what we get up to in our sex lives isn’t always easy to discuss with one another for a lot of very understandable reasons.

Jake: Well, as I demonstrated. I’m not like that. But I might be introducing HIV every single time I have sex with another man. If I
sleep with a guy who doesn’t know his status though… which is more dangerous.

Greg Owen: Bingo! But an undiagnosed guy is not stigmatised. Even though 80% of new HIV infections come from undiagnosed ‘negative’ guys. You are preaching to the converted.

Let’s put it this way… when I was HIV negative I happily slept with HIV positive guys that I knew were undetectable and who I knew well enough to know that they took their meds regularly and I was even aware enough to try not to put myself in that position on the Tuesday after a Bank Holiday weekend when a HIV positive guy might have been out partying and high since Friday and not taken his meds for 3-4 days therefore resulting in a viral spike above the (generally accepted) 400 mark which starts to become HIV infectious again. I KNEW all of this stuff and I played by those rules ‘most’ of the time but I also slept with other ‘negative’ guys who were ‘definitely sure’ they were negative. I knew the risks and I took them. I’ve told you I can’t pin down the point when I contracted HIV but what I can categorically tell you is this….

I did not get HIV from a HIV positive guy…. I got HIV from a HIV negative guy!

Of course the exchange was from a person that had the virus in their system and technically was HIV positive but there is no doubt in my mind that he was still under the illusion that he was HIV negative.

So I get you. xx

Continue reading “PrEP ain’t for you…or is it?”

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The Year of No Fear – HIV today

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What does it mean to be HIV positive today?  

I was diagnosed on 12 August this year and I was lucky. I was diagnosed in what I call ‘the year of no fear’.

Thanks to the PARTNER study and the PROUD study our HIV status, be it positive or negative has less potential to polarize and divide us. The PARTNER study showed that condoms were no longer needed to prevent HIV transmission so long as the HIV positive person had an undetectable viral load on HIV treatment (ART). The PROUD study showed that HIV negative men taking daily PrEP (Pre-Exposure Prophylaxis) were protected against HIV transmission, again even without condoms. For the first time in 30 years we truly have the opportunity to live and thrive as HIV equals.

So I was diagnosed as HIV positive and publicly disclosed my status immediately because I felt empowered by this knowledge and fearless because of these studies. Sure, there would be social hurdles but that’s the amazing part – I’m not a Scientist or a Doctor. They have done their bit by affording me these comforts. Now it’s my turn to do my bit. I’m just an everyday person with no clinical background but what I can do is change people and their preconceptions. I can – we all can.

But the opportunities expand well beyond just deconstructing stigma and establishing equality. We now also have the chance to start winning the fight against HIV and AIDS. It’s time to look to San Francisco for the beacon of hope and pioneering example.

San Francisco is the only city that have stabilised their number of new HIV infections. In the last 3 years they have delivered a 30% reduction. The reasons why are simple. TasP (Treatment as Prevention) where anyone diagnosed with HIV is on effective ART (Antiretroviral Therapy) and are therefore undetectable and non-infectious, combined with PrEP for HIV negative people. 

Always seemingly a step ahead, San Francisco embarked on their RAPID initiative, involving 39 men from July 2014 to December 2014, which implemented a process of treatment at point of diagnosis. This in effect speeded up the process of beginning ART (Antiretroviral Therapy), preventing people from falling out of the system by collapsing some of the steps of the care continuum. Thus reducing the window of onward transmission from infectious newly diagnosed patients.

In the UK the clinical benefits of earlier treatment were shown in an international study called START. It is undoubtedly one of the most important HIV studies of the last decade. It was designed to look at the benefits and risks of early HIV treatment (ART). The results were both exciting and reassuring for people living with HIV today. The following is from HIV i-Base.

Main findings include:

  • HIV treatment was safe for people starting HIV meds with a high CD4 count. Many people in START had a CD4 count above 800.
  • Early treatment led to fewer serious AIDS-related illnesses, even at high CD4 counts.
  • The biggest [negative/general health] impact from early treatment was expected to be on illnesses like heart, liver and kidney disease and some non-AIDS cancers. The opposite was true in that early ART reduced HIV-related illnesses. This is big news.
  • The results were similar in both low- and high-income countries. This should result in making HIV treatment more available in all countries.

Secondly, the results show that benefits of treatment and prevention overlap. Other studies have proven that treatment dramatically reduces HIV transmission. Now people using treatment as prevention (TasP) will know there are direct benefits for their own personal health as well as that of the community.

Ultimately, it’s not about us and our generation. I have two 5 year old nephews and I would love to think that by the time they are in their 20’s that we will have managed to reduce our number of new HIV infections in the UK to such a low level that neither of them need ever worry about contracting HIV as I have. It is for them and our children that we need to take responsibility and action now!

We need to manage and reduce this country’s alarming and unacceptably high number of new HIV infections. Let us put the focus back on the AIDS crisis. There is still an AIDS crisis. Not in this country, here in the UK we have a ‘new HIV infections’ issue – not an AIDS crisis. But in sub-Saharan Africa and even as close by as Eastern Europe and Russia they still have an AIDS crisis.

Our brothers and sisters before us did not die of AIDS so that we could become complacent with HIV and allow ourselves to be immersed in AIDS apathy. It started with them, it can end with us. We have the tools to stop and end HIV and AIDS. We need to use them. 

We can’t allow our privileges to diminish our responsibilities in this global healthcare issue.

Continue reading “The Year of No Fear – HIV today”

FUCK other STIs

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It has become clear to me over the last few months that we have a very real problem as gay men. We really don’t talk about our sex lives HONESTLY. Particularly with regards to sex and condoms. This is one of the main reasons why we have seen new HIV infections rise and rise – year after year. 6000 new HIV infections were diagnosed in the UK last year alone (and countless others that are yet undiagnosed). I’m going to go way out there and just state it as I see it. Put moral judgements aside and stop debating what we (gay men) should and shouldn’t be doing. The simple fact is that people do not always use a condom for penetrative sex all the time, every time. Yesterday I had a conversation with a friend of mine who had told me previously and several times that he “doesn’t really ever bareback” but he did at the weekend. He’s now on PEP for the next month. In my own case, even though I had spells of busy sexual activity, I didn’t bareback that much or over a long period of time. And when I did have condomless sex I always tried to box clever. I of all people am very real proof that no matter how HIV aware and educated you are – you can’t outsmart HIV on your own.

If I had have been able to get PrEP I would still be HIV negative.

PrEP is only about HIV protection – it doesn’t claim to offer protection against any other STI. So it’s infuriating for me to constantly hear this “what about other STIs?” sensationalism and attempted counter claim to the benefits of PrEP. It’s like saying wearing a seat belt won’t stop you getting cancer! Of course it won’t! It’s not designed to protect you from getting cancer – it is designed to help protect you in a car should you have a driving accident. PrEP and HIV protection is exactly the same. PrEP is amazingly effective at protecting you from HIV! That is what it is designed for – nothing else. Every other STI can be immunised against or cured – even Hep C (Harvoni is the new treatment). Yes, drug resistant gonorrhea is obviously a concern but you can catch that from oral sex. And realistically…how many people wear a condom for oral sex? Very few. You can catch every other STI from oral sex.

So please stop and think about this before screaming about ‘other STIs’ when discussing PrEP.

In my experience people who want PrEP don’t want it to START barebacking – they want it because they ALREADY ARE barebacking.

They are aware that they are taking risks and they just want to protect themselves. Personally I think that is amazing and that these guys should be commended.

I have so much interaction with the users of our website. It’s incredibly inspiring and exciting. This has been an amazing year for HIV awareness, anti-stigma and HIV prevention developments. Next year is going to be a hugely transformative year in the HIV arena. The future is PrEP – the future is here!

Continue reading “FUCK other STIs”

PrEP is NOT about SEX

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PrEP is NOT about sex. PrEP is about HIV prevention and the deconstruction of HIV stigma.

Too often online I am met with PrEP shaming. In fact all variants of shaming. You name it and you can be guaranteed that someone will directly or indirectly set about trying to shame you for it. This is our first battle. The battle within ourselves and within our community. Just STOP IT! It’s not helpful or constructive. Fuck it! I will go as far as saying it’s darn right destructive and obstructive!

Why do we do this? And why is bareback sex BAD sex? I’ll tell you why! Because no matter how much we think we may now be accepted and integrated into a mainstream society we are still conditioned to believe that we should not be free to enjoy the kind of sex that we like. It’s a case of…

“Yes, you can fuck that guy up the ass but you better do it with a condom – otherwise you will catch HIV as punishment for being a bad gay”

Or…

“You can fuck that guy up the ass but how dare you ENJOY that sex without a condom because you are using PrEP”

This is in essence what other people are conditioning us to accept. And you can see how ludicrous those statements are.

Originally condoms were used for pregnancy prevention. Condoms were for straight people. Then when AIDS arrived, condoms were for gays and AIDS protection. The kind of sex gay men were engaging in ‘pre-AIDS’ was condomless sex. This was natural, good sex. Now condomless sex is seen as bad bum sex! Barebacking – it even sounds dirty, dangerous and feral.

I honestly couldn’t give a fuck who chooses to wear a condom and who doesn’t. That is each person’s own choice and to be negotiated with whomever he chooses to interact with sexually on a situation specific basis. No one has the right to impose their moral judgements on anyone else. Especially not when it comes to something so personal and intimate as the kind of sex we should or should not be having. As long as we are all responsible and considerate. PrEP is both responsible and considerate.

I find with people in general (not just gay men) that they don’t respond very well to being told “DON’T do this” or “DON’T do that”. Instead what they respond to positively and embracingly is been offered something they ‘can DO’ ie be given the choice of opting in for PrEP.

Here is an unused section of the interview I gave to HIV Equal. I thought it was worth sharing .

PrEP and slut-shaming
PrEP has been stigmatised here but attitudes are changing quickly, people are really switching on to the idea now… here is a post that I put on facebook…

“It seems our PrEP website users are as capable of taking matters into their own hands as much as we are… We haven’t managed to secure ANY funding yet and so currently have no promotional and marketing budget to allocate to producing some branded items… But Mark (our first IWPN user to post his PrEP delivery) has decided that he’s got this covered! He took the artwork and logo and created (and paid for) his own www.iwantprepnow.co.uk  t-shirt that he is proudly going to wear on holiday!!! You see this is what PrEP is all about!!!! Forget about ‘little blue pills’ forget about ‘sex’!! It’s not about that – it’s this simple…PrEP can help our mates stay HIV negative and help kill stigma towards HIV positive people like me. It’s a community thing that benefits ALL of us. PrEP ‘shouldn’t’ be my fight!!! It’s too late for me to take it…so that is EXACTLY why it IS my fight and YOURS TOO. We all want to help our mates stay happy and stay healthy… We ALL support PrEP – it might just take some of us a little while to realise it – but that’s cool too Xx”

How www.iwantprepnow.co.uk came about
I started a big push on raising awareness of PrEP at the beginning of this year. No one else was really doing that here in the UK. As the momentum and interest grew so did the volume of messages I was getting in my facebook and Twitter inboxes. More and more guys were contacting me directly asking for info and where/how to get PrEP. I was struggling to keep up with the enquiries and so I spoke with my buddy Alex Craddock the co-founder of IWPN who was and is currently using PrEP (daily) as HIV protection and we agreed that it was a bit ridiculous that there wasn’t 1 place/site with all of the basic info you need about PrEP, supporting documents and links to trusted sites to purchase tested and verified generic PrEP. And that was its point of conception. Neither of us had the capacity to continue acting as an online PrEP help desk or call centre for PrEP info and access. We did some research and had some guidance from the right people and within 4 weeks we were live.

PrEP and the NHS
It is frustrating of course because over the last 30 years in the battle against HIV and AIDS, despite everyone’s best intentions and efforts – what we have been doing has not worked. That is not to diminish the huge amount of work, passion, heart and soul that my peers and predecessors contributed. Until recently the use of condoms, abstinence or remaining in a totally 100% monogamous relationship with another HIV negative person were the only options. Recently though with the release of the findings from The Partner Study we have discovered and begun to acknowledge and accept that condom-less sex with a HIV positive and undetectable guy is also HIV safer sex, it is practically impossible for an undetectable guy to pass on the virus.
Now we have the option of PrEP as another tool for HIV protection. The protection PrEP offers is close to 100%. A guy in the Damon L Jacob’s Facebook group ‘PrEP FACTS’ worked out the figures…here they are from his calculations…

“Almost nothing in medicine is 100%, probably including PrEP. But the research suggests that daily Truvada reduces the risk of acquiring HIV by 96% or even 99%. At 99%, that takes your 1.4% per incident risk down to 0.014%. If an HIV-postive partner is on effective HAART and virally suppressed, there is additional 96% risk reduction (at least), bringing the 0.014% down to 0.0006%. This is very close to zero.”

To put it very simply and at the risk of setting myself up for attack from ‘condom advocates’…

Condoms – even readily available FREE condoms aren’t working to reduce new infections.

If you don’t use a condom every single time you have any sex even oral sex then you are not 100% protected and even if you do manage to use a condom every single time you have sex – it can still break.

And this is the beauty and game changing potential of PrEP. If you take PrEP daily – you are HIV PROTECTED!

Here in the UK it costs the NHS about £20,000 per year to treat a HIV positive person. But to provide Truvada as PrEP for a HIV negative person would only cost the NHS about £5000 per year. If you want to take that a step further, generic PrEP can be purchased through our website for about £45 per month. So a year’s supply would only cost £540. That is one hell of a price comparison.

Of course these are just figures and price tags. The human/emotional value of helping someone remain HIV negative is priceless and on that front we can no longer shrug our responsibilities.

For the first time in 30 years we now have the chance to start winning. Winning against stigma too. If a negative guy is on PrEP he doesn’t need to concern himself with anyone else’s HIV status because he is protecting his own HIV negative status (and his sexual partners HIV negative statuses) by using PrEP – he is in total control.

San Francisco is the only city that have stabilised and are now reducing their number of new HIV infections. The reasons why are simple. TASP (Treatment as Prevention) where HIV positive guys are on effective ART (Antiretroviral Therapy) and are therefore HIV undetectable and non-infectious combined with PrEP for HIV negative guys. Can you see how perfect this combination is?

Positive guys can’t pass on HIV and negative guys can’t catch it. This is how we are going to win.

It’s not about us and our generation. I have two 5 year old nephews and I would love to think that by the time they are in their 20’s that we will have managed to reduce our number of new HIV infections in the UK to such a low level that neither of them need ever worry about contracting HIV as I have. It is for them and our straight friend’s kids that we need to own this and take responsibility and action NOW!

My long term goals for PrEP and TASP are to manage and reduce this country’s alarming and unacceptable number of new HIV infections then once we have our house in order lets put the focus back on the AIDS crisis. There is still an AIDS crisis. Not in this country, here in the UK we have a ‘new HIV infections’ issue – not an AIDS crisis. But in sub-Saharan Africa and even as close by as Eastern Europe and Russia they still have an AIDS crisis. We can’t allow our privileges to diminish our responsibilities in this global health care issue.

Continue reading “PrEP is NOT about SEX”

DO YOU KNOW

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(Photography by Laurie Poole – click here)

I have said from the very start of this journey that I wasn’t going to regret what has happened in my past that led me to this point. That I wouldn’t deal in ANY guilt and that I would be a winner not a victim. I have said it before – no one gave me HIV. I made choices and as a result of those I got HIV. That means, me, myself – I. I am the only person I am holding accountable. But ‘Do you know who?’ is a common and regular question that I get asked by people when discussing my life and HIV positive status. That question pisses off some HIV positive people and I can understand why. I’m cool with the question because I also understand why people ask it and I can always see the huge immediate and potential  future benefits of being kind and straight up enough to allow and encourage ANY discussion.

“Do you know who?”

My answer is always the same. No, I don’t. And It doesn’t matter to me. It’s done now. I can’t change it. Why waste that energy trying to figure it out and drive myself nuts with endless questions upon questions. I don’t need to allocate blame. I can better use that energy and mental capacity to change the things I can. Stigma and PrEP have been the things I identified (even when I was HIV negative) that I could change and drive awareness of. So I picked my battles. They are my battles and I refuse to have a battle with myself. One thing my diagnosis changed in me was my tendency to mope about things and waste my emotions and frustrations on things that really didn’t warrant the gift of my attention. In simpler terms – I went from having a very low tolerance to bullshit to having ZERO tolerance to it!

Another thing that I have said before and that I have expressed my gratitude for is the fact that I haven’t been excessively sexually active this year and although I obviously had been having sex where I and other people would have been at risk of HIV. From the little bit of deduction that I could do, I thought that I could be pretty sure that I hadn’t passed it on to anyone else. There was one guy that I was kind of seeing earlier this year that I got in touch with the day after I found out and he just by chance had been tested the week before and was still negative. As soon as I knew he was OK and informed about the situation and my family knew, I then posted that I was HIV positive on facebook – for 5000 friends. I knew that would indirectly take care of informing anyone else that might have concerns.

But it wasn’t really that simple and that wasn’t exactly the whole truth.

There were 2 guys that I have had sex with in the last year that stuck in my mind as people that I maybe should have got in touch with personally. The first guy – Carl, who I fucked and came inside of at a sex party, wasn’t someone I exchanged contact details with. I didn’t know how to go about finding him. And the other guy – Marco, who I met at a party and spent the best part of a day with. A really sweet, funny, sarcastic guy who I genuinely connected with – even through the haze of chems. Marco was a facebook friend so I guessed he was taken care of.

The truth is I really couldn’t find the courage at that point to make contact. I wasn’t shaken too much by my diagnosis but one of my biggest fears was that I had given the virus to someone else – admittedly without knowing but it still had the potential to kill me with guilt. I don’t like guilt. As life would have it Carl (the guy from the sex party who I came inside) was in my Sainsbury’s local 5 days after my diagnosis! I was not prepared to see him, let alone almost trip over him. I completely freaked. I was suddenly aware and anxious that because of the amount of attention my HIV facebook post got that he would probably now know trough someone else even though we’re weren’t friends. I don’t think I have ever made my way from the fruit and veg aisle to the till and straight back out of that Sainsbury’s in such record breaking time!

I felt cowardly for sure but what were my options?

It’s hard enough to speak to someone you have fucked at a sex party in your local supermarket when you are both sober at the best of times – let alone when you’re trying to drop in ‘Maybe you should go for a HIV test’.

That was back in mid August and over the last few months I’ve let go off a lot of that crazy stuff you do to yourself when you’re first diagnosed. It’s called normalising. But life, circumstances and coincidence weren’t done with me just yet – as I was about to find out….

Last month there was a ‘secret gig’ on at Heaven where I used to work and I was running a guestlist for it. I invited 1000 of my ‘London friends’ on facebook. All they had to do was turn up at the door and give my name.

I was outside Heaven in the smoking area having a cigarette on my own when all of the sudden Marco walks into the smoking area. There were only 2 other guys and then Marco and I. I had just lit my cigarette and he had just lit his – there was no option of fleeing this situation ala my Sainsbury’s sprint from Carl. I looked at Marco square in the eye as he did me and we both smiled and said ‘Hey’.

Inside I was not saying HEY! Inside I was screaming and praying that it wasn’t flashing up on my face like a neon sign.

I could tell from the look in his eyes that he KNEW.

He knew and he wasn’t going to bring it up. I could feel he was going to be kind. I could tell he was nervous but I also didn’t find him as shocked to see me as I was him.  I was genuinely happy to see him again but my smile was pure fronting. I couldn’t allow myself to do anything other than front some sort of cool HIV confident calmness.

No one prepares you for these moments. There is no way to. All you can do is hope for kindness.

It was over to him now. Before I knew it there had been a hug and a polite and friendly kiss on the cheek. I told him that I was really surprised to see him out in a gay club (he’s not out to his family, they are a very prominent Catholic Italian family and not so cool with the whole gay thing). Marco said that he’d seen my facebook post and he wanted to check out the gig – so he was actually here on my guest list! I found this a little bit hilarious too! A non-out guy – at a secret gig for a new boyband that was also being hosted by a drag queen from Ru Paul’s drag race – which he loves!

I was hoping for his sake that he didn’t let his family flick through his Sky Plus ‘recorded programmes’ or the cat might be out of the bag and ‘sissying that walk’! I was pleased that he’d felt confident enough to show up at something that was so out of his comfort zone. We had a really pleasant chat and the usual banter. I explained that my date was inside and that I needed to get back to him. It was all very courteous and I thought – cool. That’s that all done and wrapped up now. Wrong again….

Last week I was invited to the re-launch party of Gay Times magazine. I was pretty nervous because big industry events make me kind of anxious. I’m standing at the bar – drinking too much free prosecco and replying to an email when I look up from my iPhone and see Marco strutting towards the bar! Oh for fuck sake! Like I’m not anxious enough already!? – this dude is here too! I couldn’t figure out how the hell he’d actually managed to get into an ‘invite only’ gay media event as someone who….

A – isn’t out as gay and B – doesn’t work in media!!!

It’s also totally bizarre because I had just been thinking about him during the week and how I was a bit proud of him for deciding to try to start owning his situation and his sexuality a bit more.

I remembered that I’d inadvertently hurt Marco a little bit at the party we met at earlier in the year by too harshly proclaiming that I would NEVER have another boyfriend or even date another guy that wasn’t out to his family. As soon as I said it I could see his heart sink. Not because I’d dashed his hopes of dating me – we fucked that was it. But because I had shamed him and removed a bit of his value and worth – just because he hadn’t managed to navigate that part of his life yet. That was totally unintentional but none the less quite mean and a bit cruel – I should have been more mindful and kinder. But at that point in my life as a result of the pain I’d endured because my ex had struggled with this same thing, I really could not see any valid excuse why an educated, funny, confident, clever and very emotionally intelligent man in his 30’s could not have ‘the balls’ to be out to his family.

Without disclosing too much of Marco’s personal circumstances, after he licked his wounds for an hour or so, he told me why he wasn’t out to his family. And it had nothing to do with being cowardly, it was out of love.

Despite the fact that he was noticeably disappointed by my ignorant and quite arrogant dig at him earlier – he didn’t lash back. Instead he settled himself and afford me the privilage of hearing his story. Which must have been hard for him to tell. I knew it was not a story he told often and I appreciated his honesty, vulnerability and openess. He taught me about him and his situation and more importantly he taught me about me and changed me a little bit.

This is something a lot of people don’t understand about gay men. Sometimes we are in episodes of taking drugs and having reckless sex but there is always a reason why. Usually a very simple and understandable reason why we are behaving in certain, sometimes reckless and often unhealthy ways. For me it was because I was heart broken from the fall out of a 7 year relationship. For Marco it was the struggle to be gay without the option of coming out to his family and establishing solid foundations for himself as his true self.

I hadn’t been in contact with Marco apart from a couple of facebook messages in the few days after we met at that party, had great sex and great conversations. But Marco and the insight he gave me has stayed with me. And here he was at the same party as me again for the second time in a month. There was the standard smile and a hug. I asked him if I needed to block him from my facebook? If he was going to keep turning up to events that I was at. Stalker much???

He informed me that actually my DJ friend Chris who was playing at the party had invited him. I thought – how cool! You came to one gig, met some of my friends and made them your own friends and now you’re doing your thing. I was really chuffed.

When Chris had finished his set. I told him Marco was here somewhere and that I didn’t know they had become friends. Chris then just casually dropped in ‘Oh yeah Marco! I’m kinda seeing him, he’s here as my date’

FOR FUCK SAKE!!!!

I thought all my HIV bullshit and anxiety was wrapped up and packed away….but here it was again!!! Biting at my ankles now!

Marco – a guy I fucked bareback while I might have been HIV positive was now seeing my mate and I haven’t had ‘that’ chat with Marco yet!

I felt physically sick at the series of possible knock ons that I could see unfold in front of me. I don’t know what part of me kicked into gear at that point but it was clear that Chris, Marco and I were all going to spend the next few hours hanging out together. Now was not the time to try to address this situation but it became very clear to me that now was certainly the time for me to stop running. I could see the direct implications this might have on my friend Chris and his health if I didn’t own this at some point really soon. I think total temporary denial kicked in. I would deal with this tomorrow when I could pin Marco down privately on facebook.

So the day after the party, with a stinking hangover and pure dread in my belly, I reluctantly opened the discussion and most likely the can of worms with Marco. It all started very cautiously…

Greg Owen : Hey Marco was nice to see you again last night. I’m pretty sure you know all of my shade was in good humour but just thought I’d make sure. It’s actually very sweet to see you hanging out with Chris..he’s a really nice guy. It is a ridiculously small world!! X

There was a good 20 minutes of messages back and forth. Finding any sarcastic, borderline offensive or shady thing throw at each other before I could pluck up the courage to make my opening. I don’t know Marco well but I know him well enough to know he knew exactly what was coming. I made a pitch with…

Greg Owen: So I was a bit freaked out when Chris told me you were seeing each other

Marco reassured me that he had told Chris that we’d hooked up before and Chris was fine with it but he was sorry if  that made me uncomfortable but why was I uncomfortable?

I still hadn’t found the momentum to drop HIV into our thread yet so it reverted back to me saying that I just get uncomfortable about things like that because I don’t like upsetting anyone or muddying the waters with my friends…I was trying every creative version I could think of to address the elephant in the room without actually having to say it – I got the feeling he was doing the same thing.

Eventually the anxiety got to me and I just took a leap of faith.

Greg Owen: It’s ok, it’s cool. I don’t mind you talking to him about it but I’m gonna be a bit honest now…I was a bit freaked out because I haven’t asked you if you got tested since I found out I was HIV+. I didn’t ask you when I saw you at Heaven because that’s a really personal thing and I didn’t think it was appropriate for me to ask you that, especially in a club….

Do you mind if I ask you if you have had a test since? Because I don’t know when I contracted HIV and we fucked bb. And I kind of really hope that I didn’t put you at risk but I don’t know.

Btw this is incredibly hard for me. I haven’t actually had to have this conversation with anyone until now.

Marco: I have since and you don’t have to worry. 

It is a hard thing for sure but nothing you can take responsibility for. It’s a choice both parties make and in that scenario choices may be skewed

But that’s why you are fighting to put preventative measures in place – like PrEP

Greg Owen: Oh god! Ok….I actually felt really sick asking that question. I still feel a little sick

Marco: Really you cannot take that onus upon yourself. I was of sound mind and choice

Greg Owen: I know

Marco: Maybe less sound mind but definitely choice

Greg Owen: Lol. Ok thank you. I just panicked. I could see a chain of upset linking straight to Chris and I didn’t like the concept of that. But I’m glad it is not the case

Marco: It also isn’t a difficult chain to connect. You weren’t good at board games were you

Greg Owen: Lol. Fuck off

Marco: Hehe

Greg Owen: I‘m ‘bored’ of this game you mouthy fucker

So I was relived. But after an hour, when my anxiety had settled down a bit, something about that last set of messages was niggling me….so I read them back…..Then shit got REAL…..

Greg Owen: Btw – I just read your messages back and I didn’t realise that you didn’t tell me you were negative. Just that ‘I don’t have to worry’ I presumed that meant negative. You don’t need to tell me either way. It’s not my business but I do want you to know that if you are positive you don’t have to worry that I’m going to think ‘you gave it to me’ no one ‘gave’ me HIV – ‘I’ got it – I take full responsibility for that

Just wanted you to know that too xxxxxx

Marco: I did check and yes I am positive. It’s something I’ve been trying to deal with and have mentioned it to Chris

I would appreciate if others didn’t know until I’m ready I guess to accept and share

Greg Owen: Ok. That’s cool. Thank you for telling me. I NEVER discuss anyone else’s status

Marco: Hehe I’m sure 🙂

Greg Owen: It kind of goes with the territory. I need to adhere to good practices

You do it your way. YOU are the only person you need to worry about in regards to this

Marco: I had wanted to talk about it but the most important thing for now is baby steps

Greg Owen: It’s yours to own xxxxx

Marco: Thank you xXx

And you are a great guy. And I Admire what you are doing – That stays on here though, never to be repeated! LOL. I’m not going to start being nice to you

Greg Owen: Yes….everyone’s journey is different and no one does it ‘wrong’

Right for you is right for you

I’m actually really really glad you told me

Did you get tested after you found out about me?

Marco: No before. I had been acting a bit recklessly

Greg Owen: Well, we both had.

You on meds yet?

Marco: It’s quite common these days. Yes – I am on meds

Greg Owen: Speak for yourself – I’m not common! 🙂

Marco: Haha it’s just second nature for you. It’s best to start meds as early as possible

Greg Owen: What meds you on?

You know what, I haven’t tried to figure out the who and when

To me – it really doesn’t matter

It’s a waste of my energy

Marco: Me neither, no benefit really

Ritonavir, Truvada and Prezista

Greg Owen: It’s kinda a bit nuts cus only 1 person has cum in my ass since I tested neg last Easter. And I been 60-70 % top since too

Marco: Most likely that but not necessarily

Greg Owen: Just goes to show – you can’t always box clever

Precum has the Virus so it can be that too

It’s been weird that we bump into each other again

Marco: It really is. I don’t classify that day as a random chill out or sex party

Greg Owen: I’m sure life makes people collide for a reason

Marco: I believe that too! – I did enjoy it. Had a good time and enjoyed connecting, talking, etc

Greg Owen: Wow – so we were thinking the same thing

I’m gonna square too so this is out of the way…I was kinda shocked to see you a few weeks ago… you threw me

Marco: Why’s that?

Greg Owen: Because there is only you and 1 other guy that I thought I should have got in touch with

Marco: It was hit and miss. I had palpitations the way there. Only went because I had my therapy session before hand and agreed I should check it out

Greg Owen: Palpitations why?

Marco: I was just very nervous

Greg Owen: Seeing me (HIV related) or attending that kind of ‘gay’ event?

Marco: Attending that kind of event but no I felt relaxed to see a familiar face

Greg Owen: This is gonna sound weird… We can’t really tell if our HIV was exchanged between you to me or me to you when we met…. IF AT ALL. Could easily have been other people.

But in the oddest way…if you exchanged it in my direction…I’m kind a little comforted to know that the exchange was from a person who’s actually kind of a decent guy

I say that cus I had a bit of a horrible situation/experience with a guy earlier this year and it makes me kind of a bit sad if it happened in that situation.

Btw – this is ONLY between you and I

I don’t share these thoughts with anyone else

Marco: Of course…I confided in you too remember

You can be assured I hold what you say in utter confidence

What an interesting and weirdly sweet thing to say

I guess it’s part of 21st century ethics

There’s your story next time you write something

Greg Owen: I know…I trust you. I should probably explain. It’s more that I haven’t had this conversation before with anyone and it’s not thrown me or upset me. So it’s more a case that I think this is the most personal conversation I’ve had about my HIV. I don’t think I could share/write about how this conversation just played out

There are little bits of me and the HIV thing that I want to keep.

I mean it’s heartwarming to know that we have been able to have this conversation without any fear or anger. And I truly appreciate that x

Wow – I didn’t read your message until now

That’s a little freaky that I was typing about not being able to write about this as you suggested I should lol

Marco: Of course. I understand that you are sharing and want to be there for others. But there’s an element of personal journey to it. As opposed to just personalised

I appreciate this too x

It is a bit freaky we just had the same but different thought! 🙂

Greg Owen: I think you might be right (for once) maybe when I process how I’m feeling right now it would be worth sharing this story. It is so worth sharing. I need to let it sit with me for a bit. Xx

Marco: X

Greg Owen: I honestly have to say – this has been the strangest 24-36 hours

The amount of coincidence is ridiculous

Marco: Hehe what else did you do? WHO did you do?

Greg Owen: Lol. Shut up. You know what I mean – This conversation NEVER would have happened if you hadn’t been seeing Chris

Marco: Very true

Greg Owen: So out of a lot of panic and anxiety came a nice thing. Cus we just talked and were honest.

Marco and I wrapped up our conversation and then I was suddenly really emotional…..

Greg Owen: Ok…I’m not sure why. Genuinely don’t know why but our conversation just made me cry – properly like floods (about me) for the first time since I found out that I had HIV. I’m pretty sure this is a healthy release but very unexpected and I feel really really weird right now. Totally not sure if I should be sharing this with you either but as it was our chat that caused this reaction I thought would. I’m OK just a little overcome. I guess I should thank you.

Marco: That’s sweet and I appreciate you sharing that. No need to thank. It’s being able to share that makes us understand and deal with things

Greg Owen: I’ve stopped crying now!!! Lol. Thank god

I only cried for half an hour

But that was enough

Marco: It Sounds like a healthy release and it is lovely to be a part of. I wasn’t there physically but the communication and bonding are the same nonetheless. 🙂 Aww x

Greg Owen: It wasn’t so lovely for me today lol

It was a bit traumatic

But I am glad it’s out and done now

END OF CONVERSATION

I think the reason I was so emotional that night after our conversation was because Marco released a few of my internalised fears. I could have infected him…or he could have infected me or our HIV could have come from another situation. We really don’t know but that doesn’t change what we DO know…..

We both DO know that we aren’t angry people. We’re not gonna hate on each other.

Instead, we are most likely going to build on what looks like the start of a healthy friendship. Having already established respect, understanding, support and most importantly the liberation and unburdening that comes from being honest….nothing more – Just honest.

I can rest easy now knowing that my friend Chris is not at any risk from my HIV through Marco.

But above all, and this is as honest as I have ever been. I have had a constant niggling anxiety since I was diagnosed. That one day me being cool with being HIV positive would pass and that I’d be filled with some malignant hidden anger that was lurking in the shadows. I was truly petrified of becoming that person. Thanks to the chat I had with Marco – who may or may not have been the exchange point for my HIV…the fact that I didn’t have it in me to be angry with him. That I just wanted us both to be cool, released that horrible anxiety that I have been carrying around and afraid to admit for the last couple of months. I cried a whole lot that night and it felt really good and I feel like I put down a bit of baggage that I hadn’t realised was so heavy.

Thank you Marco and thank you Chris.

Continue reading “DO YOU KNOW”

Get free P(r)EP on the NHS – NOW

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You can get Truvada to use as PrEP for free on the NHS – NOW. Here’s how…

There IS actually a way to get PrEP for free on the NHS. It means working the system! And being a little bit dishonest. But if a little white lie is going to get you some free drugs to keep you HIV negative – is it forgivable? This process is called ‘clinic hopping’ more specifically ‘clinic hopping’ for PEP. And claiming a false risk of exposure to HIV

PEP is 4 weeks of treatment that is offered free if you have been at risk or exposed to HIV in the last 72 hours. They will test you for HIV at your appointment and do all the base line liver and kidney tests etc. Some sexual health clinics will give you the whole month of pills straight away at your first appointment. Others will give you 1 week of treatment and then you have to return for a check up at the end of that week and be given your remaining 3 weeks of PEP. So the system is simple. PEP consists of 1 Truvada and 1 Raltegravir pill in the morning and 1 more Raltegravir pill in the evening. So if you do the math and you are scamming the system for 3 pills a day and only taking 1…you are wasting 2/3 of what it costs the NHS to provide that. PrEP guys only need/want the 1 Truvada daily. So you can get PrEP on the NHS but you have to work them by getting them to give you PEP. This ‘clinic hopping’ is already a thing and is already happening in London (a lot) and with the rise of PrEP awareness and the knowledge of this method of accessing it…it will happen a lot more, at a lot of wasted expense to the NHS….Surely someone in the NHS can see this coming and behave proactively NOW to prevent this waste of much needed funds instead of reactively once we’re another year down the line….with thousands of pounds being wasted.

I know of people who will spend 1 day going around 2-3 clinics or A&E departments collecting 3 month’s supply in one day because sexual health clinics here in the UK operate a ‘confidential stand alone service’ and don’t communicate data with each other or your GP without your permission. You can in effect be anonymous at each clinic as you don’t need to provide any ID or proof of address. So at 1 clinic you could be John Smith at another you could be Peter Pepper. Some of these ‘clinic hoppers’ take their PrEP pill every other day so 28 pills actually lasts them 2 months.

I asked a representative from a leading London sexual health clinic about ‘clinic hopping’…

Are you as a clinic aware that ‘clinic hopping’ for PrEP is happening in London?

NHS availability (or otherwise) of certain drugs regarding Hepatitis C (Harvoni/Sofosbuvir ) and HIV protection in the form of PrEP have created a climate of people sourcing their own medicines their own way or sometimes ‘scamming the system’. This is entirely understandable; even heartening that people are being inventive and proactive in their desire to protect themselves and partners from infection. However, it can be dangerous when done in the absence of medical supervision, and so cannot be condoned.

So if a guy managed to get his Truvada as PrEP through this method but had queries or concerns about taking PrEP or his HIV status, what support is there for him?

What we don’t want to happen is for people to be frightened to tell us that they are scamming the system; because even though we may sometimes be limited in the medicines we can prescribe for PrEP and HCV treatment, there is still very helpful advice that our staff are able to give people doing that. No one is going to get reprimanded or told off for telling us how they’re ‘scamming the system’ or how they are trying to stay HIV negative. If someone has a supply of PrEP (regardless of how/where they sourced it) and they need advice then we can give that very practical, medical and lifestyle advice to people wishing to stay negative. We don’t want people to avoid us or omit truths because they are frightened they are going to get in trouble. We are aware there is a climate of  scamming or ‘clinic hopping’ for medicines and – though we can’t condone it – we encourage people – guilt free to come and tell us what they are doing to try to stay HIV negative. The desire to protect ourselves and our partners from infection,  is always an admirable and commendable one; full disclosure, can help us to help you.

Continue reading “Get free P(r)EP on the NHS – NOW”

It’s cheaper to stay HIV neg. HIV+ is expensive

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I’m writing out of pure frustration today. The more involved I become in the HIV/PrEP arena the more it seems that the solutions we are desperately searching for are already here! We just aren’t joining up the dots.

I’m going to kick off trying to defuse my frustrations by starting with PrEP. Particularly in light of last Friday’s News headlines.

The Guardian, Fri 9th October 2015

“NHS hospitals’ £930m overspend prompts calls for urgent funding”

“Fears grow that hospitals will run out of money and care standards will deteriorate unless chancellor injects more cash”

BBC News, Fri 9th October 2015

“NHS deficits hit ‘massive’ £930m”

“NHS trusts in England have racked up a £930m deficit in the first three months of the financial year – that is more than the entire overspend last year.”

“Regulators said the problems were the “worst for a generation” and demanded immediate action be taken.”

So the NHS have over spent! Big surprise… Well wake the fuck up people! If you haven’t been given enough funds to start with – and you only spend what you need to – YOU WILL TECHNICALLY OVERSPEND! I’m not exactly sure why this was worthy of such sensationalist headline attention on Friday. Although £930m is a substantial figure – we need to put it into context. They overspent by £930m in the first quarter. So if we multiply that by 4 to get a projection of what their total overspend for the year would be (at current performance) that would be an annual deficit of £3.72 billion. The NHS has a total annual budget of £95.6 billion. So that equates to an overspend of 3.6%. In any budget I have ever compiled in my previous career in accounts for staffing and marketing – we always had a contingency of 5%-10% of the overall budget to allow for the unknown or to cover things that might go wrong. However…

 “The NHS are projected to overspend on their annual budget by 3.6 percent” – isn’t such a punchy headline.

Semantics aside. £930m is still a lot of money. It’s clear that the NHS needs to save money. And this is where I keep getting frustrated. Especially in regards to HIV treatment and PrEP HIV prevention. Time for some more figures (please stick with me on this)

Every single day, here in the UK, 10 ‘men who have sex with men’ – that’s gay or bi men (cis or trans) catch HIV.

10 gay/bi guys a day get HIV.

Let that figure settle in for a moment.

HIV treatment for a positive guy (drugs + health care ie seeing Nurses and Consultants + any counselling that might be needed) costs approx. £20,000 per person, per year

So if we say 10 guys per day get HIV…there are 365 days per year…

10 x 365 = 3650 guys per year

3650 guys x £20,000 = £73,000,000 (per year)

So with our little series of calculations we can all agree that new HIV cases will cost the NHS £73m per year.

With that £73m figure in mind. Let’s work out the cost of giving 3650 guys PrEP for a year.

I’m using the price from Dean Street’s PrEP clinic website…

1 month of PrEP costs £400

 So 1 year’s PrEP costs 12 months x £400 = £4,800 per person

3,650 guys x £4,800 = £17,520,000 (per year) to keep these guys negative. Negative guys generally won’t need to be in clinics regularly or require on going health care and support for HIV – if they haven’t got it.

Now we can work out how much the NHS would SAVE if none of these 3,650 guys ever got HIV because they were all on (free NHS supplied) PrEP

£73m – £17.5m = £55.5m

STOP THE FUCKING PRESS!

We could actually (in theory) save the NHS £55.5 million per year just by getting our mates on PrEP and keeping them HIV NEGATIVE…..

Doesn’t take a genius to work it out…..

MAKE PrEP AVAILABLE FOR FREE NOW….

JOIN THE FUCKING DOTS…….

Continue reading “It’s cheaper to stay HIV neg. HIV+ is expensive”