PrEP: No Holy Grail but no cause for sexual moralisation either

Surely, the ruling that the NHS can fund the distribution of PrEP can only be seen as a positive development? Apparently not. Lee Williscroft-Ferris is troubled by some of the reactions to this historic decision.


This week’s High Court ruling that the NHS can fund PrEP should have been universally heralded as a milestone in the battle to contain the spread of HIV among gay men. Instead, what we have witnessed is a torrent of misperception, conflation and outright homophobia.

Of course, we know that PrEP is not a standalone, one-stop solution to what is an incredibly complex problem. In reality, it is one tool in a larger HIV prevention kit, but a powerful one nonetheless. So, it is with utter bemusement/horror that I have witnessed a discourse evolve that seeks to evaluate gay men’s position within some sort of imaginary hierarchy of worthiness.

I have commented before on the desexualisation of gay men by wider society. To many, the idea that two men can fall in love, get married and adopt children is all well and good; the thought of them engaging in sexual activity, however, remains beyond the pale. We are now hostages to the age of ‘marriage equality’, in which archaic notions of social responsibility enforce behavioural expectations that revolve around unswerving monogamy and participation in what is essentially a heteronormative institution. In a remarkably tragic display of pseudo-Stockholm syndrome, scores of predominantly younger gay men have allowed themselves to become flag-bearers for the kind of respectability politics perpetrated by those who demonise the LGBTQ+ community with terrifying vigour.

Of course, we know that PrEP is not a standalone, one-stop solution to what is an incredibly complex problem. In reality, it is one tool in a larger HIV prevention kit, but a powerful one nonetheless.

In the wake of the High Court’s verdict, the Twittersphere imploded with references to ‘sluts’ and ‘bareback sex’, made not by homophobic heterosexuals but by gay men desperate to disassociate themselves from what they perceive to be an act of pandering to the worst excesses of ‘gay life’. This is not just profoundly offensive but also has the potential to carry with it immense physical and psychological damage. It is worrying enough that these people would seek to deny fellow gay men access to such preventative treatment; by dismissing it so casually on the grounds of respectability, they also fail to recognise that it is also their health put at risk through the prioritisation of reputability over realism.

There is a deeply troubling presumption at the heart of all of this that HIV is the sole domain of those who have multiple sexual partners (even if it were, so what?). In truth, HIV is indiscriminate; a split condom, a drunken encounter, even the first time you choose to have unprotected sex with your partner – all of these scenarios can, and do, occur and none of them should incur the socially conservative wrath of those who should frankly know better.

The Twittersphere imploded with references to ‘sluts’ and ‘bareback sex’, made not by homophobic heterosexuals but by gay men desperate to disassociate themselves from what they perceive to be an act of pandering to the worst excesses of ‘gay life’.

This is not to dispense with the notion of social and personal responsibility. In an ideal world, everyone of all gender and sexual identities would engage in safer sex. In that utopia, however, HIV would not even exist. The fact it does means that it is entirely correct to have all possible means at our disposal to combat its spread, including PrEP. The suggestion that those who have campaigned so tirelessly for its availability have done so purely in order to usher in a more liberal era of sexual behaviour is both grotesquely objectionable and dangerously self-destructive. No matter how many brownie points such moralising may elicit from our heterosexual brethren, there are no winners when the health of LGBTQ+ people is jeopardised in such a myopic manner.

Like the smoker who falls victim to lung cancer or the overweight person who develops life-limiting heart disease, people in a high-risk category for the contraction of HIV should not be collectively punished for being sexually active. A civilised society is one that values all lives equally and that strives to ensure that no expense is spared in the prevention of chronic diseases. PrEP may not be the Holy Grail of HIV prevention but it sure as hell is the most promising development in recent times. To employ blame and shame as weapons in an over-simplistic, puritanical crusade of moral sycophancy is ill-advised, distasteful and, when perpetrated by those within our community, downright treacherous.

Follow Lee on Twitter (@calamospondylus)

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