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7 min read<\/p>\n7 min read<\/p>\n
Featured individuals were compensated for their time.<\/p>\n
HIV, THE HUMAN IMMUNODEFICIENCY VIRUS<\/a>, which without treatment can lead to AIDS, may have seemed to fade into the background over the years, but it\u2019s never gone away. More than 39,000 Americans were diagnosed with HIV in 2023, according to the Centers for Disease Control<\/a>\u2019s most recent update. Over 80 percent of those patients were men, and 66 percent of cases were attributed to male-to-male sexual contact. While HIV is preventable, it remains a reality for many people.<\/p>\n There are more ways to help prevent HIV transmission than ever. One way is with pre-exposure prophylaxis (PrEP)<\/a>, a prescription medication taken before exposure to HIV that can help lower the risk of HIV infection through sex by 99 percent when taken as prescribed. Available in either pill or long-acting injectable form, PrEP can help protect you against HIV. PrEP does not protect against other sexually transmitted infections (STIs), so condoms and regular testing remain important parts of sexual health. <\/p>\n We spoke with three gay men who actively open up about sex and dating. Here, they share their insights and perspectives about why protecting yourself against HIV matters, break down the latest HIV prevention options (with a spotlight on PrEP), and explain how these HIV prevention options have evolved over the years.<\/p>\n Meet Our Panelists<\/p>\n Jack O\u2019Brien, DO, a doctor of family medicine and HIV specialist in West Hollywood, CA. <\/p>\n John Paul Brammer, an author and illustrator in New York City.<\/p>\n Ariel Padilla, an indoor-cycling instructor in New York City. MEN\u2019S HEALTH (MH): How do you think your attitude has personally evolved over the years regarding protecting yourself from HIV? <\/p>\n DR. O\u2019BRIEN: Right after I came out, my parents met me with love and acceptance but also concern. Their concerns for my safety were rooted in the realities of the time and influenced how I navigated relationships early on. But medicine has evolved, and so have I. <\/p>\n The approval of PrEP as a HIV prevention option has changed everything about how I and everyone around me approach HIV prevention. I protect myself first. I have open conversations with others, and I get to support others by providing PrEP access.<\/p>\n BRAMMER: It\u2019s completely changed ever since [PrEP] medication became available. I didn\u2019t come out until I was in college. I remember an era where prevention was centered only on condoms. When HIV prevention options like PrEP became available, I was optimistic, but nonetheless skeptical. It took a lot of education and a lot of conversations to really understand what preventing HIV with medication could look like.<\/p>\n PADILLA: I was in an eight-year monogamous relationship, and PrEP came to be while I was with that person. At the time I thought, \u201cWhy would I need to be protected? I have a boyfriend, I have a partner.\u201d<\/p>\n After my relationship ended, I was a single person in New York as an adult, and dating again. I\u2019d heard of PrEP but until this point had never viewed it as an essential piece of my sexual health. As I learned more about my HIV prevention options and talked with my healthcare provider, I realized being proactive about HIV prevention gave me a lot of peace of mind. When you have multiple partners and don\u2019t protect yourself, it\u2019s the same as keeping a secret. <\/p>\n If you are HIV negative and having sex, you should talk to your healthcare provider about HIV prevention options like PrEP.<\/p>\n BRAMMER: I was 21 when I first was tested for HIV and I was with my then-boyfriend. We didn\u2019t really care that much for each other, but there we were sitting in that doctor\u2019s office holding hands, because they\u2019re testing you for this thing that could change your life. You\u2019re just a few words away from your daily life potentially being completely different. I was told that I was HIV negative, and I thought, \u201cI don\u2019t want to be this vulnerable. What can I do?\u201d And obviously, knowledge is the way that you get over having this concern. That started me on this journey toward, \u201cI don\u2019t want to navigate based on vibes anymore. I want science. I want facts. What\u2019s available for me?\u201d And through that, I arrived working with my healthcare provider to start on PrEP. DR. O\u2019BRIEN: I had this false sense of security in monogamous relationships until I was cheated on during one of my relationships. Then, when I was married, I engaged in unprotected sex with someone who wasn\u2019t my husband. I went to the emergency room right after to get post-exposure prophylaxis. The situation made me think: why don\u2019t I just take PrEP? That just seems to make sense. That\u2019s why I talked to my healthcare provider about PrEP. PADILLA: I recently got back on PrEP. I was sick for a long time. I was worried that maybe I had contracted HIV. I was HIV negative; it wound up being a gnarly sinus infection. The doctor and the nurse I saw were both gay men, and what was beautiful about this is that it led to the conversation about, \u201cAre you on PrEP?\u201d And I was like, \u201cI\u2019m not.\u201d The doctor set me up right in that office, and then I got the medication two days later. MH: Because people can now live long-term with HIV, do you think they may not be inclined to use PrEP? <\/p>\n DR. O\u2019BRIEN: I think so. The younger generation is so unaware of how devastating HIV was in the queer community in the 80s and 90s. Being able to take care of people in their 50s, 60s, 70s, 80s, and 90s that are living with HIV and the stories that they get to tell me\u2014they helped save my life. Understanding that history matters. It reminds us why HIV prevention is so important. <\/p>\n BRAMMER: I do think that\u2019s possible. When I came out in 2011, progress felt inevitable. We got same-sex marriage, and the White House was lit up in rainbow colors, and I thought, everything\u2019s just going to keep getting better. Because HIV treatment has evolved so much, it can sometimes feel like less of an urgent issue. But, as you get older, you learn that progress is not guaranteed. Knowing that is what really made me more committed to talking to people in my community and seeing where they come from\u2014seeing what life was like before I came out. That is what convinced me I needed to start protecting myself.<\/p>\n PADILLA: We have to change the way that we approach talking about HIV. Ask questions. Seek out a healthcare provider who understands your experience. Healthcare is a service that we work hard for in this country. If you don\u2019t like going to your healthcare provider because you don\u2019t like them, go find a new one. <\/p>\n BRAMMER: Get tested and learn the facts. Understanding how HIV prevention works gives you the knowledge you need to have informed conversations with your healthcare provider.<\/p>\n DR. O\u2019BRIEN: If someone is sexually active or unsure of a partner\u2019s status, I encourage them to get tested. With today\u2019s tools, HIV prevention can be highly effective when care is accessible and individualized.<\/p>\n Talk to your healthcare provider to learn more about HIV prevention options, like PrEP, and visit HealthySexual.com<\/a>.What You Should Know About PrEP<\/p>\n By Maria Masters<\/p>\n PrEP, which stands for pre-exposure prophylaxis<\/a>, is a prescription medication taken before exposure to HIV that can help lower the risk<\/a> of HIV infection through sex by 99 percent when taken as prescribed. <\/p>\n \u201cPrEP has really evolved in terms of the multiple options offered to people, including the longer-acting choices as well,\u201d says Namrata Shah, MD, an infectious disease physician in Washington DC and co-author of a study published on the latest PrEP offerings in The New England Journal of Medicine<\/a>.<\/p>\n You\u2019re more at risk for HIV if you have unprotected sex with one or many people, have a partner who currently has HIV, or have been diagnosed with a sexually transmitted infection within the past six months. While 71 percent of new HIV infections occur in gay or bisexual men, according to data from the Centers of Disease Control and Prevention<\/a>, anyone sexually active can get HIV. \u201cA lot of people don\u2019t know the [health status] of their sexual partners,\u201d says Dr. Shah. \u201cAnyone who is HIV negative and sexually active should talk to their healthcare provider about PrEP.\u201d<\/p>\n The problem, she says, is that many people don\u2019t feel comfortable talking to their doctor about HIV, including prevention\u2014and that doctors, too, don\u2019t feel comfortable bringing up the subject. Data<\/a> shows that there are more than 39,000 new HIV infections in the U.S., evidence that \u201cwe\u2019re still falling short,\u201d says Dr. Shah.<\/p>\n
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MH: What made you start the conversation with your healthcare provider about PrEP? <\/p>\n
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MH: What advice would you give other men about the importance of protecting themselves against HIV?<\/p>\n
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