As the famous TV commercial went from the ‘70s – “it’s not nice to fool Mother Nature.” Mother Nature has a way of exacting her revenge.
The immediate task at hand is to educate gay and bisexual men how to avoid monkeypox and to get vaccinated. But it isn’t too early to assess what brought us to this point. In the last 10 years there has been a wholesale abandonment of safer sex promotion in favor of PrEP brought to you by Gilead. The result has been the destruction of the condom culture, which was so carefully built in the 1980s in the face of the raging AIDS epidemic; a tsunami of STDs; and sustained high HIV infection rates across the U.S.
The battle lines in the gay male community over condoms and partner reduction is nothing new. It was well documented in Randy Shilts’s book “And the Band Played On” and in Larry Kramer’s play “The Normal Heart.” There has been a long-standing split between sexual freedom and prevention among gay men. There has always been a sex radical group that has defined gay liberation as absolute sexual freedom. They have denied that condoms are the primary tool in prevention or that the more partners you have the greater the risk. This reminds me of people who believe that we can continue to foul the planet because we will magically invent technical solutions that will save us. How’s that working for us?
There has been a widespread attitude that syphilis, gonorrhea, chlamydia, etc. are no big deal – take a pill or get a shot. If we have learned anything in the last few years, it should be that diseases are not static. Rather they morph into more debilitating or deadly forms. Syphilis is serious. Gonorrhea is on its way to being completely drug resistant. And now we have monkeypox that jumped from animal to human and now human-to-human. It found its perfect petri dish in condomless sex parties and porn shoots.
I can already hear the shouts of slut shaming. If you love gay men, your first priority must be to keep them safe and healthy. It is not shaming to tell them the facts.
The facts are really simple. PrEP doesn’t protect you from damaging STDs. STDs have health consequences that should not be ignored. The more sex partners you have, particularly if you don’t use condoms, the more likely you are to get an STD. The tighter the circle of partners you have – such as Grindr and other hook-up apps – the greater your odds of getting an infection.
Are condoms really such a sacrifice to protect your health? Is it possible to have great sex with a condom? Do you ever get sick of getting STDs?
Gilead, the greediest of all drug companies, is pounding our community with ads promoting PrEP and is buying favor through millions in community grants. PrEP is needed for people who won’t use condoms. But the CDC and local government have abandoned safer sex promotion in favor of biomedical options. Shows such as the popular Netflix show “Uncoupled” tell us that condoms are so 1990s.
U = U which means that Undetectable (virus) = Untransmitable (infection) is a great message if it is intended for sero-discordant couples but if it is another way of saying condoms are unnecessary then it is a problem.
Now we have monkeypox. At this point it is irrefutable that monkeypox is an STD. If you want to protect your penis or your rectum from excruciating sores a condom will help. The good news is that gay men are taking their foot off the gas. Polls show that sexual hookups are down. But monkeypox will subside and chances are we will go right back to the free-for-all of the last 10 years.
Prevention is not sexy or popular. You are stigmatized as a prude or a self-hating gay or an old fuddy duddy if you promote it. But someone has to name the elephant in the room. So many of these STD surges happen among gay men because we have more partners and we are not taking precautions. For me I would rather be the one sounding the alarm then apologizing for not having warned.
Michael Weinstein is president of AIDS Healthcare Foundation.