Just*in Time: February 2016


We have been friends (on Facebook) for a while and we met [as fellow members of] the leather community when you were Mr. Maryland Leather 2010. However, I would appreciate it if you keep my identity secret, seeing as how we are both well known in the leather community as well.

Well, I noticed that there is a spike in syphilis cases among gay men, especially in the leather community. Do you think that has anything to do with pre-exposure prophylaxis (PrEP)? My next question is about post-exposure prophylaxis (PEP). In your opinion do you think that PEP gives people permission to have sex with others and then go get the pill the next morning?
—Old Guard Leather DADDY

Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.
Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.

Thank you for writing me and forgive me for responding a little late. Since Mid-Atlantic Leather Weekend just happened, I’ve decided to use your e-mail as the one that I want to showcase for this column.

Recently, there have been surges of not only syphilis but other sexually transmitted infections (STIs) in the United States. According to the CDC (2015), in 2014 there was about 20,000 cases of syphilis that were reported. That was the highest rate since 1994 and a fifteen-percent increase over 2013. The CDC stated that 458 cases of syphilis in newborn babies; this has been about a 27.5 percent increase since 2013. There were also a reported 350,000 cases of gonorrhea, which is a five-percent increase since 2013. The CDC is also saying that researchers have found that those individuals who are taking PrEP for HIV prevention did not contract HIV; however some did contract gonorrhea and syphilis. I should also note that some researchers are saying that syphilis is being better reported and that is why the number of infections is so high.

I do not think we should stigmatize people because they choose to use PrEP or PEP. Let me first describe to my readers what PEP is and then what PrEP is.

PEP is an anti-HIV drug that should be taken as soon as someone thinks they have been exposed to HIV. PEP is only effective if taken within seventy-two hours of exposure to HIV and it must be taken for twenty-eight days. It consists of two to three antiretroviral medications. It’s not a simple regimen as you make it seem—it’s not one pill the next morning.

PrEP is a once-a-day medication taken specifically to prevent HIV, which is ninety-two-percent effective. Neither PrEP nor PEP are 100-percent effective in preventing HIV infection between humans. PrEP and PEP are both preventative measures that we need to make sure that the general population know about, including when and how to use them.

Also let me say this that there is no study that says that there is an increase of syphilis in the leather community. But let me say this: The early AIDS epidemic started right at the beginning of the sexual revolution for the gay community. People do not understand that that is one of the reasons why our community has such a big problem with HIV/AIDS. We were asked to suddenly adapt our freedom to a new situation and we were also increasingly stigmatized. We had to fight for our lives. Former President Ronald Reagan didn’t even say the word “AIDS” in a public speech until thousands of people had already died. Also being gay in the eighties wasn’t easy because we were so looked down upon; nobody gave a flying fuck about our community, except us and our allies. We went through years and years of burying friends every week. I was born in 1979 so I never did see the tragedy of the early AIDS epidemic, but my friends, especially my friends who are gay and men who have sex with men of color, are still dying.

I would like to pose a question to my readers if they wouldn’t mind sharing their opinion. With the rise of PrEP and PEP do you think that the gay community has the ability to relive their sexual revolution or has the gay community already been there done that?


Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].