Little blue pill

PrEP stigma is stil alive and well–what now?

Zachary Zane has been on PrEP since 2014.

“I was liberally using my Grindr account,” he writes in a new think piece. “Yet when my (gay) therapist brought up PrEP, I shook my head. ‘“Do I really need that? I use condoms most of the time. I’m not sleeping with that many guys.’”

That’s when his therapist said, “If you got HIV when you had access to a prevention drug at nearly no cost, would you forgive yourself?”

After giving it some more thought, Zachary decided to heed his therapist’s advice.

“I went to my doctor’s office, got tested, had my liver function checked, and started popping that blue pill daily. I still take it religiously and I consider myself lucky.”

Related: This daring PrEP video puts the sexy back in HIV prevention

As it turns out, Zachary’s reservations about taking PrEP are not uncommon. He points to a two studies published earlier this year by AIDS and Behavior.

“The stigma that those who take PrEP are irresponsible and slutty emerged repeatedly in both studies,” he explains.

The first study looked at how queer men and transgender women viewed PrEP, and how those views affected their likelihood of taking the drug. Around 41% said they believed anyone who takes PrEP is “a slut.” (Two participants already on the drug said they don’t tell people for fear of being labeled promiscuous.) Another 41% reported that they believed people who take PrEP are actually HIV-positive but are lying about their statuses.

The second study found similar results. Respondents reported beliefs that people on PrEP were promiscuous, and 42% of them said they believed a popular conspiracy theory about the drug that claims those in power (i.e. drug companies, lobbyists, etc.) are somehow manipulating access to PrEP for some sort of personal benefit or financial gain.

“These two studies reveal an alarming truth,” Zachary writes. “Slut-shaming is very real, life-threatening, and hurting the queer community.”

Meanwhile, a recent look into how teenagers view HIV and PrEP by Jezebel sheds light on whether the stigmas Zachary reports on are lessening in younger generations. (Spoiler alert: They’re not. At least, not yet.)

Related: PHOTOS: PrEP marketing campaigns get homoerotic. It’s about time.

19-year-old Kaleb Anderson, was diagnosed with HIV last year, says he and his friends never trusted PrEP from the time they first learned about it.

“We all thought it was a joke,” he explains. “We didn’t think this little pill could actually do something. Before being diagnosed, I never considered taking PrEP and I knew exactly what it was.”

After testing positive for HIV, Kaleb says he now recommends PrEP to all his friends.

“If I would have been taking PrEP, would that have made a difference in how I am now?” he wonders.

Josh Bruce, director of education at the Birmingham AIDS Outreach, tells Jezebel that teaching youth about HIV prevention is still a major challenge.

“We have huge problems with stigma here,” he explains. “We are in the Bible Belt. HIV to them means, gay gay gay dirty dirty dirty bad bad bad. Some of the more affluent schools, those are where we get the kickback of, ‘Oh that’s not a problem here.’”

And 24-year-old HIV/AIDS activist and educator Deontez Wimbley from Atlanta says education is still a huge hurdle there as well.

“There’s so much I have to untangle and weed through and disprove and demystify, to where after I’ve done that to educate in a way that is constructive, half of the time is gone,” he says. “I have to disprove certain ideas about condoms, I have to disprove that you have to be Magic Johnson to get medication. The willingness to learn is not an issue, the issue is [youth] have already learned so much and so much of it is incorrect.”

The bottom line?

Stigma surrounding PrEP is alive and well, even in younger groups of LGBTQ people, and it’s fed by misinformation, judgment, and fear. Until people can over those things, little will change.

“The folks who have the highest risk of acquiring HIV are the ones most likely prevented from taking PrEP by beliefs about what using the HIV prevention drug might say about them,” Zachary writes.

It’s time, he says, for us to stop letting stigma interfere with out healthcare and our lives.

Related: ‘PrEP Diaries’ author talks controversy, slut shaming, and how it’s more than just a “party drug”

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  • barkomatic

    When I first started taking PrEP I got a lot of judgement from my own friends about it which was sheer idiocy to me. Luckily, I’m at a point in my life where I’m able to recognize irrational and unscientific bias and ignore it. There’s no way I’m going to endanger myself because some fool disapproves.

    Fast forward and many of them now take it as well after they worked out their issues. A few don’t take it because they prefer to rely only on condoms which is totally fine.

    Before PrEP, it’s always been a danger that when you go out to bars and meet guys that later on a bad decision might be made. Now there is a medication that mitigates that risk to nearly zero and the aquisition of a life changing condition is being avoided. Of course, you can still get other, far less serious STD’s but you can get those anytime you have sex with someone even using condoms. Someone taking PrEP is more responsible than a person who thinks their moral purity will somehow prevent them from catching HIV.

  • HaguePeter

    If you are not in a monogamous relation and you are sexually active, using PrEP and comdoms (to prevent other STD’s) is a smart thing to do.
    Not all gays are sexually active or are not monogamous. The whole pro-PrEP queerty coverage does make it seem that way though.
    Yes it is very useful for the PnP community and people with several sexual contacts. But that is a minority of the Gay community. Shouting it from the rooftop that everybody should use it is advocating in a way that ‘all gays are sleeping around’. That is a message I do not condone.

    • DonW

      Where do you get the statistic that “people with several sexual contacts” are “a minority of the Gay community”? Every survey I’ve read finds that at least half of gay male relationships, probably a lot more, are open — and that doesn’t account for the many singles.

  • Truth-is-Truthy

    Okay confession time. Am I the only gay person on here who has never heard of PrEP before and had to Google it? I’m 29 with academic credentials and a very high IQ. Before reading this article I’d never heard of PrEP.

    • Kieru

      What does your age, academic achievement, or IQ have to do with being socially aware of medicine?

    • Truth-is-Truthy

      What I meant is that I’m an intelligent, aware, and well-read person. Yet, I’ve never before heard about PrEP. This article is suggesting that all gay men know about it and that it’s common knowledge. I’ve never heard about it, and an 18 year old friend of mine says he hasn’t heard of it either.

    • Creamsicle

      Early on it was discussed in the context of Truvada. Not everyone would have been interested in online discussions of a particular drug. Now that people are talking are out the blanklet term PrEP it’s become much more common for men to specifically state that they’re taking PrEP in their dating profiles. I live in a city where a lot of people come for college, and it seems like the stigma is beginning to fade among guys in their 30s who are still dating and/or hooking up.

      Maybe it’ll be like the HPV vaccine after a while, and there will be an expectation that if you’re sexually active and non-monogamous as an adult then you should have this medication.

    • Rex Huskey

      I’m sure you must have other things to worry about.

  • ohellzno

    Where I live in NH. I know a few Dozen guys that are positive on Grindr that I personally know and their profiles have gone from negative undetectable to now Neg on PreP. A lot of the yuppies in my area that are on it will only have sex with guys that are only on PreP. If you even suggest a condom they block you. I know one guy that hosts PreP parties where you bring ya bottle and are let in. I was on PreP for a year and put on my profile that I was on it. I got messages all the time from others calling me a slut, thirsty, ect. I finally went off of it because it was not worth it between the dr. Appointments and the bitchy comments guys still did want me to f them. I got off the apps for a wile and still go on sometimes and see all the same faces and lies. it makes me sad.

    • Danny595

      You really need to look at yourself and how you are living your life. PrEP or not, you can’t seriously think that having sex with an assembly line of strangers is a good way to live.

  • Danny595

    It’s not PrEP that is stigmatized, but promiscuity. And it deserves to be stigmatized. Even taking HIV out of the equation, it destroys lives. It was destroying gay life and health in the 70s. PrEP will not spare you from the 2 dozen STIs that are not HIV and it won’t spare you the horrific psychological and emotional consequences of long-term promiscuity, including depression, anxiety, loneliness, and a host of other mood disorders.

    For those committed to promiscuity, it is better that they use PrEP. But that’s like saying if you are committed to going on the Titanic, at least get a 1st class ticket so you have a better shot of getting on a life boat. Better not to buy that ticket in the first place.

    • HaguePeter


    • Thud Hardbutt

      Danny, do you not think that your own comments are thinly veiled slut shaming? To have a healthy sex life as a single gay guy does not make you promiscuous. Those of us who chose to be single & who chose to have a varied sex life are not promiscuous and whilst you are entitled to your own somewhat puritanical views, I am equally entitled to enjoy my sexual freedom.

      As a HIV positive guy I feel the emergence of PrEP is a huge step towards fighting HIV and along with safe sex practices takes us one step closer to halting the spread of HIV. We need to educate on the options available, not judge those who take responsibility for their sexual health whilst enjoying a healthy sex life.

    • EvonCook

      Danny, You can be a complete assimilationist and swallow straight values and hetero morals that have essentially condemend you and your type to hell for thousands of years, but some of us actually believe that homosexual behavior and gay liberation values will be a step up for human social evolution. We look forward to the greater society gradually realizing that sexuality, free, common and frequent sexuality, is the greatest social advancement possible which will come through straights and monogamists seeing gays naturally living happier, multi-partnered lives filled with more sexual gratification than they have ever or than uptight prigs and assimilatinst gays do. Bonono monkeys are the happiest and most peaceful primates for a good reason while your kind of judgemental and condemning attitude just swallows, internalizes and spews all the hate, jealousy and fear that heteros have always thrown at us. Will never be an assimilationist here, don’t want a “husband,” don’t want to be a wifelette, and enjoy sexual friendships and relationships with many many other human beings. I have faith we will win out in the end as smart, sensitive and sensuous people will triumph over those who value and place limitation, brainwashing, controls, fearmongering and condemnation over natural human communion.

    • EvonCook

      And, just one more thing, Danny. Please remember that HIV and AIDS is NOT a gay disease, but a human disease, and it even came into our community from straights and predominately afflicts heterosexuals in the real world, even if it did spread easily among us. How they have rejoyced to make us the poster children and used this tragedy to bolster their proscriptions against promiscuity. Be very careful about joining the “it’s god’s punishment” mindset, becasur the will come back to haunt you and bite you in the ass when they need the next round of finger pointing and self-rigteous fearmongering.

    • Thud Hardbutt

      Well said EvonCook #Peace

    • frankcar1965

      The depth and breath of your judgment and self-hate is astounding and proof of how you have been beaten down by society. Then you talk about psychological and emotional consequences? Do you not see the irony? You have been told so often how dirty and nasty you are that you believe it. This is the exact same things that they said about women when they got the pill. What are you going to say if they come up with a vaccine? Tell anyone that gets it that they are nothing but sluts? You disgust me.

  • Chris

    I’m amazed by how many people have no idea what PrEP is. But also, it’s a bit sad that people on PrEP are automatically presumed to have no morals; and that so many people who are being treated and undetectable are treated so badly. I get it, if you are divergent, you need to make personal decisions; but no need to be a douche about it. And if someone is taking steps to avoid an incurable illness, there is no need to pretend he’s anything but careful and rational.

  • andrewl

    My concern is that do we know the long term effects of talking Prep H daily?

  • andrewl

    I am an idiot I meant PrEP not the hamheroid cream!

    • DonW

      We know a great deal about the long-term effects. The first major PrEP trial was completed over 7 years ago. And the drugs in Truvada have been used for many years prior to that for treatment of HIV. There are literally millions of patient-years of experience. (Google the article “PrEP as safe as aspirin”).

      More to the point: if you get HIV, you will have no choice but to take even more meds than the ones in PrEP — for the rest of your life. Taking PrEP for a few years while you’re at the highest risk of infection is a far better bargain.

  • EvonCook

    I wish to hell that the gay media, gay medical establishment and gay community would start telling the TRUTH about PrEP and stop pandering and promoting what essentially is a real and dangerous SCAM. That is, there are many strains of HIV, some more common than others. PrEP absolutlely DOES NOT prevent the transmission of ALL strains of HIV. Therefore, the hyping of PrEP is promoting not only lucrative expensive drug sales for big pharma but giving the impression that you can throw caution to the wind and once again play with abandon sexually with no condom protection. Also, this pours money into big Pharma without them ever having to develope a CURE or a real vaccination against all HIV. So, as long as we recognze and treat PrEP as the only partial preventative that it is, you can decide how much you want to gamble on their product by risky behavior. Some queens who are near hysterical about sex have embraced PrEP as the new liberation. I realize that nothing is 100%, even condoms break, etc. but thie wholesale embracing of PrEP as the great panacea is dangerous and a little sickening.

    • DonW

      “PrEP does not protect against the transmission of all strains of HIV”: HIV that is fully resistant to Truvada is extremely rare. There have only been three documented cases where someone taking PrEP as directed has gotten HIV (and all three of them were easily treated and are now undetectable).

      No vaccine or preventive medicine is 100% effective. PrEP is well over 99% effective — far more than just using condoms alone. Adding condoms is a great idea. But a lot of people already weren’t using them. Far better that they’re now almost completely protected against HIV.

      As for it being a huge conspiracy by Big Pharma: PrEP is a drop in the bucket of the manufacturer’s overall sales. They earn far more from HIV treatment, which lasts a lifetime. Why would they have any incentive to prevent infections?

    • DonW

      No, and it isn’t going to protect you from Ebola, either. It does, however, protect extremely well against HIV. What’s your point?

  • Prax07

    If you don’t want prep equated with being a dirty whore then maybe convince the guys using it to stop putting on their profiles that they’re cumdumps, cumpigs, into barebacking, just looking for nsa hookups, wanting party & play, etc. Those are the guys I see on the apps listing prep as their only safety practice.
    Because of this I view anyone advertising their use of prep as dirty, unsafe, sluts. Not anyone I’d want to get with. Prep=whore, simple as that.

    • DonW

      There were countless profiles looking for NSA, BB, PnP, etc., long before PrEP was on the scene. Good to know those guys are now on PrEP. Would you prefer that they be doing that without any protection at all?

  • Prax07

    In fact I could have hooked up eith a really cute younger guy tonight that messaged me on scruff. Totally my physical type, good conversation, but when I read his actual profile, that he’s on prep, my interest went to zero. Again, if you’re so promiscuous that you’re at such a higher risk for diseases that you need to take a daily prescription, then you are indeed a slut.

    • junk4sts

      You’re looking at it the wrong way. Each of us has different comfort levels with risk, assuming you are HIV- (and you’ve been tested and you actually know your status) You are comfortable not using PreP, but that doesn’t mean everyone else who is HIV- is comfortable with the risk associated with casual sex.

      You cannot know anyone’s status just by looking at them, and a very high number of guys who think they are HIV- don’t actually know their status, it would be unwise just to trust a guy who tells you he’s negative, it’s just as unwise to believe a guy when he tells you he is positive but undetectable. PreP + condoms are the only tools an HIV-, sexually active guy has to protect his negative status, don’t over analyze the use of PreP, it’s simply a tool that help responsible people minimize their risk of contracting HIV.

      Some side benefits of PreP is that users are tested regularly and know their HIV status, plus they because of their frequent testing they are more likely to know if they have any other treatable STD’s. PreP is indicated for sexually active people, if you are hooking up with folks on scruff you are actually a good candidate for PreP.

  • Wayne_in_NYC

    I really find it disheartening that on an article specifically about the slut shaming stigma associated with PrEP, so many of you have stepped forward to prove, without any doubt the premise of the article in its entirety. Saying you’re on the hookup apps and yet looking down your nose judging others for being on the same exact app doing exactly what you are doing but taking PrEP as their choice for avoiding the HIV virus doesn’t make you a saint or any better than anyone else. Your “holier than thou” attitude is precisely the problem being discussed in the article. (In spite of all the distracting typos and grammatical errors!) I can’t believe you can be so judgmental of others and yet be incapable of recognizing your own hypocrisy! “I’m not promiscuous or a slut! I’m just having a little fun behind my husband/boyfriend’s back while he’s working or out of town!” When you’re pointing your finger at others, there’s 3 or 4 pointing back at you! Get down off your high horse and be part of the solution instead of being part of the problem. And to those who have never heard of PrEP, you really need to come out from under your rock more often! Welcome to the 21st century! Even most guys I met in the 3rd world country of Brazil knew about it even though it’s still only available there in clinical trials and not available for widespread use yet. Strangely enough, the trials aren’t about the efficacy of the drug which has already been established worldwide, but most are studying the slut shaming stigmatism going on and how it is getting in the way of saving lives that could be saved.

  • sydboy007

    It does worry me how many profiles that say they are on prep also are not about safe sex.

    gonorrhea is close to being resistant to current treatments.

    No moral judgement. We are free to live our lives as we want. The price of freedom is personal responsibility.

  • DonW

    One day, hopefully soon, we will have a vaccine or a cure for HIV. When that happens it will have exactly the same effect as PrEP: it will enable people to have sex without fear of HIV.

    Will all the PrEP-shamers react the same way, condemning those who get immunized or cured of HIV — because they risk becoming sluts and because the HIV vaccine doesn’t protect against other STDs?

    If you’re truly concerned about the risk of other STDs, address that head on (for example, advocate for investment in new antibiotic research). Don’t condemn people for protecting themselves against the worst STD of all.

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