PrEP (or Pre-Exposure Prophylaxis) is the use of prescribed ARVs, medications traditionally used to treat HIV, along with other HIV risk reduction methods to prevent acquiring HIV for individuals who are HIV-negative. PrEP has been approved by health organizations around the world since 2012, yet stigma and misinformation continues to be a major barrier to PrEP uptake among individuals and populations who could benefit. As PrEP continues to change the way we embrace sexuality and sexual health, our language will continue to grow as well. This is a living document, and by no means perfect or comprehensive, and as such will continue to be updated by moderators and members of the Facebook Group “PrEP Facts: Rethinking HIV Prevention and Sex” to reduce stigma in how we discuss PrEP, HIV Prevention, and Sexual Health. For more information on PrEP Facts, email Michael Chancley.
Facts First!!! PrEP works when taken properly. PrEP is not 100% effective, but no prevention method is, but facilitating a discussion with facts can be much more effective than scare tactics to dissuade PrEP use or to judge HIV risk reduction practices. In fact, with over 650,000 worldwide PrEP users and growing, only 4 confirmed cases of HIV acquisition with proper adherence have been confirmed as of August 2020.
Use affirming language. For example, use terms such as “condomless sex while on PrEP” or “sex with a condom and PrEP” or “sex with partner of known negative or undetectable status”. Traditional terms such as “unprotected sex” reflect a time when we had fewer prevention options. More accurate phrasing that describes a person’s chosen risk reduction methods reduces stigma and leads to more open, honest conversations about other options to reduce risk as well.
Discuss STIs without shame or blame. Sexually Transmission Infections (STIs) impact individuals who use and who do not use PrEP, and for various systematic reasons, STI rates began increasing before PrEP. Instead of blaming PrEP or shaming individuals for acquiring STIs, we can normalize regular testing and treatment, and encourage healthy, safe conversations around STI disclosure to partners, and advocate for better access to affordable screenings and treatment in our own communities. Discussing STI testing and treatment is also a great way to open the conversation about PrEP to potential PrEP users.
Don’t make assumptions about PrEP users. People of all races, sexual and gender identities, socioeconomic statuses, and levels of risk use PrEP for various reasons. Making assumptions about PrEP users or potential users risk behaviors further perpetuates stigma and misinformation. Some people use PrEP for condomless sex, some for added protection with condoms, some because of mixed-status relationships, and some just to reduce anxiety around sex. No one reason is more appropriate than the other.
Start PrEP Discussions with the understanding that SEX IS FUN!!! Sex with PrEP can be even more fun because it reduces anxiety, may increase pleasure, allows for sexual exploration with reduced stress, and it shares the load of prevention responsibilities. PrEP’s effectiveness does not rely on one’s partner or partners’ HIV status, but instead puts the user in charge of their own HIV status.