My response to The Irish Times PrEP piece

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On Thursday 20 April The Irish Times published an article Anti-HIV Drug Removes Personal Responsibility

This article was positioned as an opinion piece and one thing we can be sure of is that opinions have no place and hold no authority over facts based evidence. Presenting accurate facts and providing an opinion based on those facts is fully acceptable but this article failed to deliver that.

Several HIV experts and organisations including Professor Chloe Orkin for BHIVA and Dr Paddy Mallon for UCD School of Medicine have already highlighted the inaccuracies and errors in the very damaging statements made by the journalist.

I will be speaking from a community perspective. As co-founder of the world’s highest traffic and most widely used PrEP website, I am dismayed that a publication such as The Irish Times would run such a piece. As an advocate and activist who identifies as a gay man I accept that our community and its members will have differences of opinions on PrEP, HIV prevention and sexual health initiatives. It is concerning that rather than reach out and share learnings and experiences this journalist instead chose to write what appears to be a click bait vanity piece. This is not responsible. This is not community. This is not healthy. This is not contributing anything of worth to the debate.

Fear based messaging has never worked. It will never work. No one responds well to being judged, shamed or blamed. To further muddy the waters and confuse sound HIV prevention with moralising and toxic internalised personal issues is damaging and indicative of a lack of understand of self and of the complexities of gay life and sexuality on a community wide level.

“What I fear at the moment is a resurgence of the old “gay plague” rhetoric of the 1980s whereby gay and bisexual men are viewed as irresponsible and apathetic in relation to their sexual health.
What PrEP is in danger of promoting, in my view, is a policy of play now, pay later which the gay population can ill afford to embrace.”

We really need to work on deconstructing this concept that at some point we will “pay” for being gay. Being LGBT+ is not wrong. Living as our true authentic selves and all that comes with that, including enjoying the sex we choose is not something we are ‘afforded’ that must be charged back to us at some point. It is what we deserve. We are different as LGBT+ folk but we are not ‘less’. Different does not mean we aren’t equal.

Setting up arguments like these about “being responsible” creates a double bind. The notion that if I get HIV I’m irresponsible, if I try to prevent myself from getting HIV (using THE most effective method) I’m irresponsible.

And as if to clarify completely for anyone who is unsure: the journalist’s closing paragraph is a total contradiction in itself and of his entire ‘opinion’.

“The danger lies in transferring responsibility for risky sexual practices on to a tiny pill taken once a day rather than making informed choices and encouraging a culture of prevention rather than cure.”

I second Professor Chloe Orkin’s proposal below:

“I therefore propose that we [BHIVA] submit for publication a letter of clarification to better inform your readership of the latest evidence and guidance around PrEP.”

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Don’t let the silence do the talking

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Today was a weird day.

I have grown incredibly attached (emotionally I guess) to someone lately. That was very unexpected for me. The guy has a boyfriend. We are friends. It was safe for me to grow fond of him because there wasn’t much at risk, or so I thought. I was kind of aware that we have been pretty inseparable and to date we have not had a fall out. A few disagreements – yes but a very symbiotic dynamic which gives full licence to both to pull the other up when he is misbehaving or making less than ideal choices. Until today…

He was pissed off with his boyfriend (rightly or wrongly) it isn’t my business nor my place to get involved. But it was incredibly uncomfortable for me to spend time in their company when my friend was giving his boyfriend the silent treatment. I had a bout of the giggles. Not because I thought it was funny or was belittling their situation but because I was nervous, anxious and uncomfortable.

I was suddenly reminded and almost transported back to my younger days and particularly my teens being subjected to my parent’s quite toxic and often vicious, damaging and destructive behaviour towards one another.

I pulled my usual ‘fixer’ moves of trying to cajole my friend into a brighter more jovial mood while it was just him and I and before his boyfriend returned to join us for dinner. Trying to make light of the tension and pandering to my friend’s mood. Hey! We’ve all been there! When we just want to make a retaliation of some sort to ease our rage. But my friend went on the proper silent treatment! Literally being asked a question and blanking the enquiring party.

I cannot tell you how utterly, cripplingly, uncomfortable this makes me. I then got caught in the crossfire of a scenario that was totally of my own creation but that I quite honestly did not see as an action that would cause offence or grievance. I borrowed my friend’s phone as my battery had died and I couldn’t be arsed to boot up the laptop. I took a selfie (for a reason) and tweeted it to me from his Twitter. No big deal right? Wrong!

When dinner had ended (I left the table early as the pregnant silences were far too laden in tension for me to bear) I went to the living room to DM said friend on Twitter to ask him if me doing his ironing would cheer him up and snap him out of his mood. Only to find myself blocked from his Twitter and unfriended on Facebook.

It literally felt like a punch in the stomach. An instant dull ache hit me in a really deep part of my gut. I was so confused. It later transpired (after a very heavy handed and unwarranted warning against sending further unauthorised tweets from his phone) that if I did that again I would be permanently blocked. Now usually most of you would expect me to fly into trademark ‘Greg Rage’ and tell him about himself. But instead I was so embarrassed and more so hurt that he would behave like that towards me that I just sat there and took the dressing down and looked at him hoping that he wouldn’t see the flash of red that was now burning my cheeks.

I am totally sure none of this was his intention and knowing that this upset me in this way will probably upset him too. But it made me think. Really think about the cycle of hurt we sometimes get caught up in and how previous emotional scars re-open to bleed even years later.

I spent 7 years with a partner who was irrationally angry and moody far too often and for prolonged periods. Most of these feelings he would direct at me, sometimes directly which wasn’t pleasant but more often passively. This guy (as much as I still love him) had the ability to lower the mood of our whole home without saying a word or without even being in the same room as me. He just had a way of hitting me where it hurt. It wasn’t nice and it broke me a lot more than I realised at the time. My friend’s actions and behaviour today (although nowhere near on the same level or with the same intentions) pulled me right back to that place in my life. I could almost physically feel my past and long since shelved pain and distress again and it freaked me out.

I’m guessing he behaved this way because of something from his past that has informed him to act this way. So I’m not judging him or criticising him. Merely observing that for whatever the reasons from both of our past experiences – today wasn’t a good day.

I am aware and reflective and open enough to notice these things in myself and question them but not everyone is. I was definitely in flight or fight mode as a result of today’s events. Instead I chose neither and opted for silence and avoiding eye contact or further interaction while my emotions settled. That is unusual for me. I’m glad that is what I opted for but the reason I wrote this and the thought that crystalised was this…

What if in these situation we did choose to fight or fly? What further damage does that create and how much does that compound the existing issues and give rise to a cluster of future issues until you have an emotional minefield of issues and triggers to navigate.

The answer and the solution seems quite simple to me. Just to sit down and talk, quietly and graciously. And while I say the solution seems quite simple, I mean that…in so far as the thought…the concept…now putting that into practice is a whole lot harder and takes some balls and some skills and also the knowledge that you are loved and supported and afforded the compassion to be allowed to say you’re pissed off about something or that perhaps you fucked up. That requires trust, kindness and bravery from all parties. Sometimes those things aren’t on offer or aren’t felt enough from and by each other.

I’m sure tomorrow will be a brighter day and I am glad I have somewhere to put my thoughts in order via these posts. That is also something that I find hugely beneficial and productive. Having to think about situations and my feelings in a little more detail in order to structure a decent sentence and blog piece allows me to tidy up my mind (and my heart). I recommend it.

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