What We Can Learn About Post-Vaccine Life From Prep

Photo by @axelhotels

There were two very important pieces of news this week. The first is that three working vaccines are rolling off production lines and being distributed globally. It’s possible that people in Europe are going to start receiving vaccinations in January, maybe even earlier. We don’t know how long the tunnel is, but there is light at the end of it.

The other piece of news is that World AIDS Day was on December 1. Last week you may have noticed popping up all over social were images of red ribbons, and vintage photos of gay protest marches and ACT UP demonstrations. 

Seeing the two stories mingling on my feed, I couldn’t help but notice how much COVID and AIDS have in common. And how maybe there’s something we can all learn from the arrival of Prep into the lives of gay men.

World AIDS Day is when so many of us in the LGBTQ community remember absent friends. If you were alive during the worst of it in the 80s and 90s as I was, you’ll know how people in your world just disappeared. I was working at the AIDS Council of NSW in 1991-92. The bulk of infections in Australia had happened in 1981-82. At the time, there was a ten year life expectancy with the drugs available. 

One day someone didn’t turn up at work. And then just never came back. Then there was a flyer pinned to the office noticeboard that their funeral was in a week. A third of the office changed staff during the two years I worked there, the bulk of that from people dying from AIDS related causes. And for the rest of us, it was a silent specter walking the halls of our homes and neighborhoods.

I remember in the early days of COVID feeling the echoes of that time again. There was a disease spreading through our communities. No one knew how it was passed. It seemed unstoppable. We had no resources to fight it. Our lives became about prevention measures. We were wary of how we touched each other. We stopped having sex. Masses of information and misinformation circulated. Young people thought it was something only older people got. No one understood why it hardly affected some yet killed others quickly. We were angry with people we judged to be careless. We shamed friends for doing things we thought would pass it on. And it seemed strange to hear stories of people getting cancer or other afflictions, our attention was so focused on this one disease.

One with no cure.

Lockdowns even gave the world a taste of what it’s like to be LGBTQ today. Not feeling safe when you’re outside your own home. Not wanting to travel to places where you think it’s possible you’ll be harmed. The looks you get when you forget to mask up around others are like trans, queer and gender fluid folks can get for just walking around in a big city. And the gay and lesbians get for walking around in small towns. And I used to get for my ACT UP T-shirt in the 90s.

I didn’t like feeling all these feelings again. But I thought if there is a positive in this, it’s that we all now have something in common. For the first time in my life, everyone on the planet got to see what it’s like to have you and everyone you love threatened by something out of your control. With COVID everyone was scared, so everyone cared. And every resource was immediately poured into figuring out how to stop it. I hope empathy is the new virus.

But as my friend Tynan quipped, we waited all year for a vaccine and then three turned up in a week. And we all half-breathed a sigh of relief.

Make no mistake though, the year that we have all just gone through has changed us. In ways that we don’t even understand yet. I hadn’t realized how much the fear of HIV was so embedded in the back of my mind, till the arrival of PrEP in 2015.

For those not familiar with the drug, it’s short for Pre-Exposure Prophylaxis, aka Truvada. If you are HIV negative, it’s a pill you take daily to prevent HIV infection. It’s one of the pills the gay community had been waiting for since the early days of AIDS. The second one we’re still waiting for is a cure.

I was living in San Francisco when PrEP became widely and cheaply available (if you had good health insurance which is another topic). Every gay man I knew first couldn’t believe it was real. Then we spoke to our doctors and heard the statistics. We ran to pharmacies with prescriptions in hand.

With my first bottle, I couldn’t wait till I got home. I had to touch this magic pill. I had to see it with my own eyes. Tearing open the paper bag, I pulled the bottle out. Punching my thumb through the silver seal and ripping out the cotton wool, I emptied a few oval shaped blue pills into my hand.

Then all their faces came back. Everyone I’d worked with, danced with, partied with, gone to Mardi Gras with, sat in the back lane behind the Flinders with, lay on their loungeroom floor listening to an album with, spent a summer on Bondi Beach with. All of them.

And I burst into tears, crying for all these incredible men who died from a disease that had nothing like the urgency we’ve seen behind COVID.

But a strange thing happened after I started taking Prep. The fear of dying every time I had sex was gone. The thing was, I didn’t even know it was a fear I’d been carrying around. Then I noticed something else. In San Francisco, we all thought we were going to have sex like it was the 1970s. The heyday of the gay movement and liberal gay love that was derailed by AIDS. We’d all seen the documentaries of what life was like before we were out on the scene. And we wanted it.

Or at least we thought we did. Instead what happened, was that every one of my friends wanted better sex with fewer people.

And I can’t say if this was a catalyst or a co-incidence, but at the same time there was a resurgence of a book called “The Velvet Rage: Overcoming The Pain Of Growing Up Gay In A Straight Man’s World”. Written by a gay American psychologist called Alan Downs and first published in 2005, it caught fire in 2015. Every gay man I knew was reading it. 

Gathering all the information, patterns and observations he’d made about his predominantly gay clients, Downs had written what many of us found to be an instruction manual. In the sense that it explained not what just we did, but why we acted the way we do. It was a revelation for our community.

The point being that a sudden medical breakthrough prompted the complete opposite response we thought we would all have. It wasn’t to party like it was 1979. Instead, our new safety made us close our groups to smaller and more meaningful collectives. And to take journeys of self-discovery.

It will be the same with COVID. We all think we’re going to jump on planes, party in clubs, kiss strangers, socialise, go to cultural events etc. But we don’t actually know.

Also, not everyone took PrEP at first. There was sex shaming (if you wanted to take it, you were a ‘ho), there was mistrust of a pharmaceutical company we had never heard of, there were those who by nature are not early adopters, there were those who struggled to let go of decades of condom use.

Some people won’t have access to a vaccine for years. Some people will choose not to take it. And I don’t mean just anti-vaxxers. But average humans who have a healthy mistrust of Big Pharma, who pumped out these vaccines in a tenth of the normal timeframe. There will be those who want to see how long the immunity lasts in the body first. We’ll split into people who’ve vaxxed, and those who haven’t. In our cities, countries and planet.

Me, I’m all for science. I like not getting polio and smallpox. But the day that I get my jab, I might gleefully look at my list of to-dos and think, actually no. Not-to-dos. Or not-right-nows.

One of the biggest lessons I learned in my divorce and was reminded of so starkly during 2020, is that nothing feels the way that you think it’s going to. When the judge finally ordered my ex-husband and I to make and sign an agreement, I was suddenly free of an eighteen month-long nightmare. I thought I’d be buying everyone in the bar a round for weeks. Instead, I slipped into a depression because I couldn‘t figure out what it had all been for. The pointlessness of it all had me in a haze for months.

Later a therapist said to me, “You’ve been at war. Now that the war is over, you have to get used to living in peacetime.” And that is a lot harder than it sounds. You will discover this for yourself after the vaccines are available. 

These days, I say to people, “It’s not you, it’s 2020.” You can’t judge anyone’s behavior right now. Including your own. Everyone’s having one of the worst years of their lives. Unless you’re Jeff Bezos.

So, make post-vax plans to keep sane. But don’t beat yourself up if you throw that list away. And maybe follow a completely different path than you expected. One that doesn’t match everyone else’s even. San Francisco did that in 2015 with Prep. I did it in 2018 with my divorce. 

2021? Let’s see. I’m ready for it to be different from this year, and I’ll do my best to accept however it feels. And however I feel. And however you feel. Because it’s not you, it’s 2021.