A personal journey on PrEP

On PrEP & 21st century sexual health decisions that we all have the freedom to make

Rainbow ribbon awareness for LGBT concept on wooden background.

Today I start Descovy as PrEP.

It’s been a bit of an ordeal getting here, but grateful and amazed that the option is available.

I take my health seriously.

I take my sexual health very seriously.

I take my sexual freedoms seriously and responsibly.

I’m HIV-. I can’t account for that in any real way given the time, place, and the actions of my 20’s and 30’s. Nonetheless, I am.

Joe (Ralph’s partner) is HIV+. He was positive for years before we met. He told me his status on our first date.

It had been, for me, 10 years of losing friends, co-workers, lovers. It had been years working in hospice care and running a group for sero-discordant couples. It had been 10 years of shutting myself down and closing myself off to penetration of my heart and my body.

But, in that moment, I knew this was the great love of my life.

Once in a while, I have a cellular knowing. This was one of those times.

I couldn’t, I wouldn’t, let fear of transmission force me to lean out of this relationship.

I had tasted such freedoms and then sealed them off so completely for the sake of a survival that was without love, intimacy, or full sexual expression.

Why? What was the point beyond mere survival?

To paraphrase Anais Nin, it was more painful to risk remaining closed off to love and sex, than it was to risk letting them blossom.

And they have.

It’s been 26 years in a sero-discordant/magnetic couple.

We used condoms (yes, I hate them, and yes, they can be boner-killers). We were monogamous for over a decade. We learned to play both safely and deliciously.

Move Onto 2015

Joe and I had the same doctor. Great guy, and an Infectious Disease specialist. He recommended that I go on Truvada. Even though Joe was undetectable and untransmittable, we were open and sometimes I was versatile and not an exclusive top. Just to be safe, he said. I thought about it for a while and conceded that it was a good idea. I started PrEP.

Joe and I went to Provincetown a number of months after. It was a wonderful vacation. One day hanging out at the house, I asked him to bareback me.

I had not done that in decades. We had never done that.

On that day, in the rain, in Provincetown, we did. It was so beautiful, hot, intimate and erotic. As he shot inside me, everything about my youth, my sex, our sex, liberations and prohibitions, fear, death, freedom. All of it flooded my head and fired up my brain. I wanted to stay in that moment forever.

All of the feelings, all of the sexual territory that had been ceded so long ago, the intimacy, the vulnerability, the fucking lust and abandon of the moment flooded me.

I never thought I would have that again.

I couldn’t let him go.

We clung and cried.


So, when I got my doctor’s email that he was concerned about elevations in my kidney functioning, come back for more tests and go off the Truvada in the meantime, it was not transactional for me. It brought up the same fears, the same losses, and rolled back a freedom that had been granted and now might be withdrawn.

I went back. Gave more blood for more tests.

Still elevated.

I could go off Truvada or I could change frequency to “on demand” PrEP which might have a lower toxicity – this means taking 2 tablets anywhere from 2 to 24 hours before sex, one tablet 24 hours later and another one 24 hours after that (it’s called 2-1-1). This way you lower the overall exposure and therefore toxicity of the medication. Or. I could try Descovy, which wasn’t FDA approved for PrEP so not covered by insurance.

It has been a rough bunch of months making these choices. When people say these are simple decisions, I believe, they are wrong. The answer may be obvious but the process of getting to a decision isn’t simple. At all. I have stayed on the daily dosage of Truvada. I’m comfortable with that choice and any ramifications. My body. My decision.

Today, however, I start my daily dose of Descovy. It is now covered, and my co-pay is the same. They believe that the small percentage of people who have side effects with kidney function and bone density on Truvada will do better on Descovy. I’m betting that I’m one of them.

Today I have hope and security in my decision. Today I have gratitude for the advances that have been made thus far. Today my joy is tempered with the knowledge that we still have no cure. So many decades, so many lost, and still no cure.

I am not a warrior. I am a survivor.

I am not a “Truvada whore”. I am a fully expressive sexual being.

I take my health seriously.

I take my sexual health very seriously.

I take my sexual freedoms seriously and responsibly.

Every day. •


Written by Ralph Bruneau

Ralph was International Mister Leather 2017 and is a regular contributor to Alphatribe.

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