In a recent episode of RuPaul’s Drag Race UK season five – the makeover episode – 65-year-old gay Switchboard volunteer and retired builder, Peter, said that condoms saved his life.
One might presume, correctly, that Peter was being questioned about his life during the 1980s and 1990s, when the AIDS epidemic tore through the gay community, in particular, killing tens of thousands in the UK alone.
“There were hospital wards full of gay men dying in the ’80s”, Peter told contestant Michael Marouli – with whom he had been matched with for the episode, “and so I used condoms and I think that saved my life... That safe sex message was drilled in the calls we took.”
Decades on, a drug now exists that the gay community of years gone by tragically could only dream of – PrEP.
PrEP stands for Pre-Exposure Prophylaxis, and it’s a pill that HIV negative users take daily (in most cases) to prevent themselves from contracting the HIV virus through the use of antiretroviral medicines.
As a sexually active, single gay man living in London, I can tell you that PrEP is hugely popular today. In fact, the National AIDS Trust gives that in 2022, 86,324 people initiated or continued PrEP in England – a majority of whom were white gay, bisexual or other men who have sex with men.
Resultantly, it won’t come as a shock that I myself am on PrEP, but the question I’ve been turning over in my head for some time is this – is PrEP alone enough to keep you safe when engaging in casual sex?
Well, many a gay man in 2024 seem to think so. In fact, I can tell you that PrEP is all the rage and condoms, well, are not. I’ve even heard of and experienced a lot of gay men actively rejecting sex where a condom is involved. This can create a sort of pressure to not use condoms, even if you would prefer to.
Of course, this isn’t true for every gay man today. Indeed, a brief survey of my local area of London (carried out via Grindr) provides a varied, if London-centric, picture of how the gay community uses condoms in 2024.
That picture shows that while some believe condoms are still an important part of casual sex, others believe an approach that involves taking PrEP and carrying out regular STI tests is enough to stay sexually healthy.
Now, any PrEP user will know that the drug only protects one from contracting HIV, and does absolutely nothing to prevent picking up a whole host of other sexually transmitted infections. So, to engage in intercourse casually without a condom does inevitably carry the risk of some sexual infections.
Still, the argument among many gay men seems to be that the availability and efficacy of treatment for STIs means that sex is worth having sans condoms.
The fact that some gay men disdain condoms and prefer to take PrEP only seems slightly ludicrous when you consider the history of our community, so I decided to reach to a sexual health expert to find out whether this is truly a safe way to engage in casual sex.
Dr. Lori Beth Bisbey is a registered psychologist, sex and intimacy coach and accredited gender, sex and relationship diversity therapist.
When asked whether PrEP users should also be using condoms when engaging in casual sex, Dr. Bisbey affirmed that they should, adding that PrEP only protects against HIV, and that there are plenty of other diseases that can be contracted. These range from antibiotic resistant gonorrhoea through to herpes and hepatitis C, which can be dangerous and/or lifelong.
But what about combining PrEP with regular STI testing? Dr. Bisbey says it’s a matter of the level of risk a person is willing to take.
“I don’t judge people for taking risks – we all take risks. I judge people for not fully considering the risks. For some, this is a risk they choose to take.
Regular STI testing tells you what has happened after the fact. It assumes that you can get treatment for anything that PrEP doesn’t cover, but this isn’t so.”
Some also debate the long-term effects of taking PrEP, since the drug is relatively new, but Dr. Bisbey insists that avoiding HIV is of primary concern: “For some people, there are potential kidney and liver impacts, so usually blood work is done every 3 months to check health. However, most healthcare professionals will suggest HIV prevention is crucial.”
Ultimately, it seems that PrEP has made a positive impact in our community in terms of HIV transmission, and its effectiveness cannot be understated.
However, as brilliant as PrEP is for stopping one contracting HIV, its futility against other sexually transmitted infections should be ignored.
While it indeed comes down to the risk you’re willing to take when having casual sex, perhaps it’s time we all realised that condoms aren’t just there to kill our buzz – they can save you a lot of time, hassle and, in the worst circumstances, ill-health.