The Curious Case of PrEP Abroad

During my last trip to the Philippines in January, I decided it was important to explain to everyone I was chatting with on Grindr, or meeting in person what exactly PrEP was. This is because “the Philippines has registered the fastest-growing HIV/AIDS epidemic in the Asia-Pacific in the past six years with a 140-percent increase in the number of new infections” according to the Philippines’ Health Minister Paulyn Ubial. It was only in July 2017, that a pilot study “Project PrEPPY” was launched in the Philippines, to combat this disturbing epidemic in which “83 percent of new HIV cases occurred among males who have sex with males and transgender women who have sex with males.”

Throughout the course of my stay, I took it upon myself to message hundreds of people on Grindr about PrEP, stating “It’s a drug that helps HIV negative people stay negative. Brand new here in the Philippines. One blue pill that you take every day. Register here and you’ll be contacted: http://www.loveyourself.ph/p/prep-basics.html

As a Filipino American on PrEP, I felt a personal responsibility to educate anyone who may be unaware of PrEP, to answer any questions they might have, generally point them to organizations and resources that could answer more specific logistical questions and ultimately provide direct access to PrEP, and overall spark the conversation of what PrEP means among the gay community. Project PrEPPY eventually proved successful and PrEP soon became more widely available by the time I returned to the Philippines in January. Additionally, The LoveYourself Project is a sex positive, LGBTQ sexual health organization in the Philippines that specifically “aims to prevent the spread of HIV/AIDS among the youth and key affected population through awareness, counseling and education.”

I’m certain that many PrEP users would agree that it allows a reasonable sense of safety. This safety may or may not ease us into wider sexual possibilities, feeling more free to take risks with lesser fear and paranoia. The choice to take PrEP can be a vulnerable process, especially if your sex partner is not particularly educated on PrEP or HIV. Since touch is still highly stigmatized by people around the world, it’s crucial for every PrEP user to discuss with any potential sex partners what it means to be on PrEP and use this discussion as a safe sex, educational practice.

In the Philippines, getting the knowledge out to educate people was simple, but in-person praxis was a different story. Coming into the Philippines with my set perspective as a PrEP user, I was in a position of privilege, via protection and education. It was crucial to voice that fact, especially because people may have vastly different understandings of safe sex methods and levels of knowledge. Two starkly different episodes come to mind, framing my overall landscape of “teach” and “touch.”

One night in Manila, a guy asked to come over and give me an innocent back massage. When we met in the hotel lobby, there was immediate sexual chemistry. We were in bed cuddling, vibing, and he smelled freshly showered and sexy. I drew closer to him and he ran his fingers up and down my back. We were building a feeling of trust and intimacy. When he asked to have sex, I told him I was on PrEP and what that meant. Then I felt him physically recoil and wilt away from me.

“You really turned me off just now.”

I explained to him that I use condoms most of the time, sometimes not, but that I did have them if we decided to. We untangled ourselves, fumbling through the doomed awkwardness. I tried educating him about HIV contraction, PrEP being over 90% effective, and strict testing standards, yet he remained despondent. He eventually said, “what if the last guy you slept with unprotected was your 10% [and gave you HIV]?” I was crushed. I felt vile and judged. I coldly turned my back to him, feeling exasperated, thinking “how the hell did our budding warmth devolve into this petty bitterness?” He continued to demean my personhood, until I kicked him out with damaged determination.

A few days later, I met up with someone else. This guy did know what PrEP was, and although he was cautious about being with me, he saw its value. “Are you judging me?” I asked him a couple times. With a smile and nervous laugh, he assured me that he wasn’t. I took his word for it. After enough open dialogue and freely expressing concerns, we chose to use a condom. It became one of the finer moments of touch throughout my trip, because as much as we judge ourselves in or out of bed with someone else, it’s always nice to feel accepted, from someone who won’t, even for a moment’s pleasure.

Ultimately, I take PrEP because I want to be responsible and I want to be as safe as possible in my sex life. Taking responsibility means letting moments of touch flourish purely whilst sharing knowledge. When you’re in bed with someone and your clothes are all off, you have both silently agreed to withhold judgment from one another, for however long you embrace. Let the clothes fall. Let the love pour. Let the care be there — care in your touch and in how best to keep each other safe. When we talk about the way we touch, we not only share more heightened intimacy, but we also practice safer sex.

Now that PrEP has become increasingly ubiquitous among the wider gay community, beyond the digital space of Grindr, the conversation has grown to allow deeper, more disenfranchised sects of our community access to the benefits of PrEP. Despite its criticisms, there’s certainly proof that PrEP is working. But it took time to get where we are. As Gilead continues to expand access to PrEP worldwide, we will need as much time time as possible to help international gay communities reach a thorough level of understanding and adherence. Fortunately, this is something we can all contribute towards, since intimacy can be intelligent, passion can be purposeful, and times of touch can have teachable moments.

 

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