My PrEP Story: Will (part 3)

We have a duty to provide harm reduction information to people, even when they don’t follow universal precautions, says Will Nutland. Finger wagging and scolding make people less likely to reach out for health services, should they need them.

My PrEP Story is the personal voice of people who are using, or have used, PrEP, and those who have been at the forefront of providing it and advocating for it. Find out more about their decisions to use PrEP, how they have navigated using PrEP, and their very own PrEP journey.

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I spent the weekend before last doing something I haven’t done for almost 20 years. After reading guidelines and articles from around the world, I wrote tips on how to have safer sex. I jumped online and asked friends and acquaintances what they most needed to know about sex and being ‘safe’ during these COVID times. The end results are these tips about having non-physical sex and harm reduction information during physical hook ups. The information is heavily built upon and influenced by the excellent work of JD Davids.

None of us need reminding that casual physical hook-ups during these times can put us, our partners, and others we’re in contact with, at potentially huge risk of picking up or passing on COVID-19 (and if you did need a reminder, there it is). These are extraordinary times and the universal precautions around hand washing, physical distancing, isolation and quarantine will save lives. But what should we do when people don’t follow these universal guidelines? 

Chris, who featured on UK’s Solent Radio last month, was adamant that these universal guidelines shouldn’t apply to her. She spent her weekend out for a walk, went shopping at Asdas, and visited her 78 year-old friend, before returning to her husband, who has a serious health condition. She even took some flowers to the cemetery. Chris was adamant that the advice is “silly” and driven by panic and she intends to ignore it, despite the consequences.

Chris’s reaction might be extreme and illogical but what information should we provide to people who don’t or won’t follow “the rules”? 

In the early 2000s both THT and GMFA started to provide information for gay men who weren’t (always) using condoms. That information was evidence based, as well as being based on the reality of having sex during that time. Many men were already having sex without condoms and the information built on the risk reduction strategies men had worked out for them selves. Both Matthew Hodson (then at GMFA) and I (then at THT) took a lot of flack for putting that information into the public domain (just as some of the earlier HIV prevention pioneers had taken flack for suggesting condoms and other safer sex techniques, other than total abstinence). The flack isn’t dissimilar to the criticism we get for educating about PrEP (hi Foxy) rather than telling (yes, telling) people to always use condoms. That harm reduction information provided options for people to be safer (not safe, safeR), when they weren’t following “the rules”.

As I asked my buddies and peers across the weekend what information PrEPster should be providing, I came across a familiar pattern. Some wanted us to put out information to control the behavior of others. I heard that all sex apps should be closed down; that people should be told in no uncertain terms that hooking up right now is wrong, selfish, self-destructive and will “give us all a bad name”; I heard that people who break these new “safer sex” rules should be named and shamed. Some people told me that the only information we should be giving out was around total abstinence and, as Nancy Reagan said about drugs, “just say no”.

And I also heard something else that’s familiar. I heard from people who are scared, who are confused, and don’t know what information sources to believe. I talked to people who are lonely; who are stuck in living situations that they desperately don’t want to be in; people who rely on sex as their main income source; and people who have been in “lock-down’ for days and weeks and just want connection with someone else. I chatted with people who want to be held or touched; people who want to smell or taste another person; and people who want to filthy-fuck-this-stressful-and-terrifying-situation-out-of-their-systems.

During these scary and uncertain times, it’s easy to move to shaming, to judging, and to having expectations of our selves and others that are tough. I know of friends and of previous hooks-up who are having hook-up sex (for all the reasons above, and others). It’s easy from the sidelines to slam that (especially if we have the luxury of someone to cuddle up with) but all of us deserve information to help us to stay as safe as possible during this time. 

As health promoters, and as a community-based organization that has a reputation in the communities we work alongside, we have a duty to help people understand the risks of COVID-19. We have a duty to provide information in an accessible, evidence informed, ethical and balanced way.  And we have a duty to work alongside everyone to do all they can to be as safe as possible during these COVID times.

And as health promoters, and as a community-based organization that has a reputation in the communities we work alongside, we have a duty to provide information to help people reduce their harm when they don’t follow those universal precautions. We know that no amount of scolding from us will stop people having hook-ups if they decide to. But we also know that finger wagging at those who hook up will make them less likely to reach out and seek health services, if they then need them. That’s not good for their health. It’s not good for the health or our communities.

So, the information we put out last week helps those of who need to quench our horny thirst to do so without physical hook-ups. It provides tips about doing text, phone or cam sex (and we’d love to add to that list – please email with suggestions to add). And the information we put out also provides tips for people who are having hook-up physical sex to do so as safely as possible. Be as safe as you can out there.


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