Preparing for PrEP

Photo by N. Maxwell Lander


I came of age at the advent of the AIDS crisis. To me, sex and death were intertwined, even when HIV medications turned a terminal illness into a chronic condition. Sex felt like playing a game of Russian Roulette.

Yet when has sex not scared the living daylights out of people? In Henrik Ibsen’s 1881 play Ghosts, the character Oswald pleads with his mother to help him end his life should his syphilis wreak havoc on his body. Fast forward to 1975, when country music legend Loretta Lynn sang about how “The Pill” finally gave her control over her reproductive destiny.

I was not going to let sex scare me. I was going to own my sexual destiny. I’m not the marrying type, and it would be so easy for those in long-term committed relationships to smugly look down on those of us who consider ourselves sexual adventurers. They would rather see us as sexual outlaws. But in the summer of 2017, I met a sexual adventurer who shared with me that he’d gone on PrEP (Pre-Exposure Prophylaxis), also known by the brand name Truvada, the pioneering preventive drug shown to be effective in blocking HIV transmission. The Monday morning after our weekend fling, I set up an appointment with my doctor to ask about the drug.

My doctor didn’t bat an eye and immediately set up a plan. The first step was to get tested for HIV, since the drug could have an adverse reaction if I was positive. I took the test. A week later, my doctor told me I was negative.

But then he asked me if I had health insurance. I did, from my white-collar job, but I didn’t know if it covered PrEP. The only way to find out would be to take the prescription to the pharmacy and have them run it through. Without insurance, there was no way I could pay the hundreds it would cost monthly out of pocket. The white-collar boring desk job I loathed going to each day might be my only hope of getting on the drug.

I gripped the prescription in my hand on the journey to the pharmacy and considered whether PrEP was a game changer. The advent of penicillin and the birth control pill changed the way that people felt about the consequences of sex. Would PrEP do the same?

I asked the pharmacist to check to see if Truvada was included in my plan. He punched some keys into the computer. This would be it, the deciding factor. Dispassionately, not knowing my angst and eagerness to include this supposed protection into my sex life, the pharmacist looked up and over to me and said: “You have eighty percent coverage, so you’ll pay a difference of $150 a month.”

I was in! I was a member of a new subculture. Fifteen minutes later, I was out on the street, heading home with a bottle in my bag. Two subway connections and a short bus ride later, I entered my quiet apartment. I took off my jacket and shoes and carried my bag to the kitchen, where I poured a glass of water.

Then I paused, wondering if I would now become one of the maligned, so-called “Truvada whores.” So be it, I thought, as I placed the pill on my tongue and swallowed it down with water. A sensation came over me, similar to the one Meryl Streep has when her character drinks the potion that promises to make her eternally gorgeous and youthful in the film Death Becomes Her.

This big, blue pill wasn’t an elixir of youth or beauty, but it was liberating. I craved men with a new urgency. I would now see my desires through.


Jason Armstrong’s second book, Getting Off: The Unlikely Chronicles of a Solosexual on PrEP, was released this past August. His essay “Solo- and Autosexuality 101” appears in the current issue (March-April 2020) of The G&LR.


Read More from Jason Armstrong