We Need More Compassion Along with PrEP

Dr. Chris Donaghue, Ph.D., LCSW, CST READ TIME: 3 MIN.

The foothold of sexual shame and stigma run so deep that they are easily unearthed, even with the creation of a new medication that promises to end the HIV epidemic.

As a critical psychologist who is aware of the pitfalls and damage of Western medicine and big Pharma, I carry the awareness of both dark and light sides to the presence and use of the medication PrEP (aka Truvada, a pre-exposure prophylaxis) and its impact upon both sexual health and sexuality itself.

Nothing as culturally charged and sex-related like the pill PrEP can exist without causing a ripple effect upon its targeted audience and the wider social-sexual milieu. We get viruses, infections, bacteria and germs from door handles, sick babies and the gym, so why does getting it from sex then become a "dirty" stigma-based experience? Because, like the opening credits of Law & Order SVU erroneously reminds us, anything related to sex is "especially heinous." But, it is not! And that's the issue with PrEP. Organizations like AHF (Aids Healthcare Foundation), want us to believe that sex is bad and dangerous and leads to other infections (gasp!), because of dating/sex apps and condom-less sex. But the apps and PrEP aren't the problem -- the way we use them, and treat sex, is!

Our culture hates sex and also teaches us a deep, individualistic narcissism that tells us we have no responsibility for how we treat "others," or how we make them feel. We lack a sexual ethic and allow ourselves to see others as "tricks," "hook ups" or "random dudes on Scruff," all of which are a dehumanizing way of divesting responsibility and compassion. Sexual stigma, which drives many infections, is sustained by near sociopathic app dating norms, which allow for behaviors admonished in our offline lives. Sexual racism (yes, listing races you do not wish to be contacted by is racist), body shaming and calling those who have yet to get an STD "clean" are all forms of sexual bullying that, thankfully, most of us would never engage in when face to face -- but which, in the online world, make sexual honesty and risk disclosures unsafe.

In addition, if you won't have sex with someone that is HIV positive, on their meds and taken as prescribed, thereby making them unlikely to transmit HIV to a partner, please educate yourself. If you think STDs make people "dirty," please educate yourself. If you think those on dating-sex apps are not healthy, able to be intimate or in committed serious relationships, again, please educate yourself. You are not mature enough yet to be dating and having sex.

PrEP proposes to almost completely remove the ability for infection with HIV (up to 90 percent when taken daily), which is clearly a good thing. What it does not remove is sex phobia or narcissism. The current rise in STDs is due to sex stigma and silence. My clients are well aware of the anxiously vulnerable moment of disclosing an STD, the social chatter about those who have an STD and few want to enter into this and as a result not all will disclose or get tested. No one wants, or deserves, punishment for having had sex and for getting an infection, any more than those that do so from a sick co-worker at lunch.

The solution to most "sexually-related issues" is shame reduction, education, honesty and compassion. None of that is achieved by blaming apps or medications for our cultural sex phobias and narcissism that allows us to treat others poorly.

The take-home point is that sex can be safer and more enjoyable if we stop treating it as a separate issue, special case and something to fear. I do not agree that sexual confidence or lack of sexual fear is a bad thing. The fear tactics of organizations like AHF have clearly not worked, yet they continue to attack PrEP and dating-sex apps like Tinder and Grindr for "causing" STDs, sidestepping that their fear mongering, sex-phobic campaigns themselves are part of the actual issue.

Next time you "log on," actually "take it seriously" and talk to and treat "others" as though they are people and with compassion. Don't gossip or discuss others' status, and remove sexually shaming terms like "clean" and "dirty," or "masc" and "femme." The point of sex and dating is not to terrorize others and sustain oppression, but to enjoy, relate, connect and "get off." PrEP, along with big Pharma downsides and its side-effects (this bad boy will wreck your liver) carries benefits, but a pill cannot do the social-sexual work we need to do, which is to treat each other better.


by Dr. Chris Donaghue, Ph.D., LCSW, CST

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