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Editorial: Prevention Matters
| Last updated: 25.08.04 |
As a positive gay man, one of my chief concerns is that I keep my HIV infection to myself. That is not to say that my sexual partners are not equally responsible for their own health, sexual or otherwise. However, I feel better about myself knowing that I continue to do everything I can to prevent passing on my HIV during the most intimate of acts.
Current prevention methods – I hesitate to call condoms and safer sex negotiation ‘prevention technology’ – are not even close to 100% effective. Our knowledge of HIV transmission risks continues to evolve; people are human and make mistakes; condoms, even when used correctly – can fail; and the fundamentalist notion of abstinence and/or lifelong monogamy, is laughably, perhaps even tragically, unworkable in the real world.
These grey areas around HIV transmission have led to a huge amount of personal anxiety around sex during the past two decades, which has frequently impacted upon the quality of my life. And so I welcome the forthcoming UK guidelines on PEP for sexual transmission – and more importantly, the imminent promotion of PEP’s availability to those who are most at-risk of either passing on or acquiring HIV-infection.
The availability of PEP certainly isn’t going to make me any less careful, or caring, during sex. After all, PEP is not 100% guaranteed to work, either: it relies on accessing the drugs as soon as possible after likely transmission – ideally within 24 hours – and requires the PEP recipient to stick to the regime. But knowing that there is a safety net – let’s think of PEP as a last-ditch attempt to prevent HIV infection after a possible act (or acts) of sexual transmission – helps to alleviate my anxiety as I continue to walk the sexual tightrope.
Edwin J Bernard, Editor
edwin@nam.org.uk