Prevention: The Sequel

by David Waggoner

savid-sq[dropcap]J[/dropcap]ust when you thought it was safe to go back in the water….As I watch news coverage of the recent shark attacks off the Carolinas, I’m reminded of the movie sequel tagline. Jaws 2 tried to recapture the horror of Spielberg’s summer blockbuster, but it sunk as quickly as a deflating raft. Oh, it made money and provided some chills and thrills, but audiences dropped away. Fearsome images are like that—they may strike panic for a while, but the panic fades and your everyday practices of protecting yourself become waterlogged.

I’m not trying to be glib about the recent shark attacks, but, as many have pointed out, these attacks are just not that common. And they seem to be getting more play than the seven or eight Black churches in the South that were recently burned to the ground in the wake of calls for anti-racist progressive change after the tragic shooting in Charleston. What I am trying to point out is that safer-sex messaging based on fear is a “franchise” that needs to be retired once and for all.
Fear-based messaging may heighten awareness among sexually active individuals for a brief time, but it does not zero in on how individuals go about their daily lives. Individuals have sex, and sometimes they think about protection and sometimes they don’t. Sometimes they are aware of risks, and sometimes they aren’t.
We need something stronger than telling individuals to just say no to less-safe sex because you can never trust anyone, because HIV is swimming around out there like a ravenous shark, because a sexual partner is a boogeyman. HIV is a fact of life—it shouldn’t be wrapped in moral platitudes or stigmazing discourse.

PrEP is that something stronger. Its efficacy as a prevention method is built upon a solid scientific foundation. Adherent use provides more than excellent protection. Our cover story subject, actor and AIDS activist Daniel Franzese is a proponent of PrEP, encouraging his friends to seek out its benefits. “We need to talk about getting rid of these abstinence programs and bringing back needle-exchange programs which work. Abstinence programs do not. We…need…to…be…realistic,” he shares.

But what is very revolutionary about PrEP is that it has reignited a new era of counseling and care. The PrEP programs that Larry Buhl reports on in this issue are not based on “handing out pills.” These programs actively enroll individuals, and very often, those individuals are negative or status-unknown gay and bi men, into a prevention program that includes testing, counseling, linkages to care, and an ongoing dialogue about staying in care. In short PrEP has helped to empower individuals to be proactive about their healthcare in general and their sexual health and self-care in particular. In doing so, our PrEP practices potentially bridge the structural inequities that create an environment of risk and our individual histories, flush with the thoughts and feelings that make us feel that we cannot change the status quo, personal or societal.

Former NFL player and LGBT activist Wade Davis has stepped up to the cause, as Alina Oswald reports. As an ambassador for PrEP Up Alabama, he is helping to launch AIDS Alabama’s latest prevention campaign. The campaign is reaching out to young men who have sex with men, particularly Black and Latino men, who are reportedly the least connected to care among gay and bi men.

Importantly, Housing Works’ newest online social media campaign, #PrEPHeroes, reverses the notion that we are waiting to be rescued. As the stunning images in this month’s Gallery attest, we are the heroes of our own lives. We can rise to the challenge of empowering ourselves and helping to empower others.

Don’t get me wrong, I’m all for sequels. But those second and third chapters of our lives should take us in new, liberating directions—not retread the same old fears just because that’s what’s expected.

David Waggoner is Editor in Chief and Publisher of A&U, the first national HIV/AIDS magazine in the U.S.