PrEP is driving a paradigm shift of queer life in the United States, but the revolution’s parameters are complicated. We are not witnessing the end of HIV and AIDS in the United States — queer people, especially queer people of color, are still contracting the virus at disproportionate rates, and people still die of AIDS.
But the science is clear: people around the world take Truvada for PrEP because it prevents HIV infection. A 2015 Kaiser Permanente study of 600 high-risk individuals found that none of them contracted HIV over the 2.5 years they were observed taking PrEP. Studies have shown that even nondaily adherence to the regimen provides a strong degree of protection. Sherer says PrEP users in France only take a pill four times a week and references this to answer those who dispute PrEP’s utility in public health efforts because some patients do not take it as directed. (He still advises his patients to take Truvada every day.) “Disco dosing” — taking PrEP only around periods of riskier sexual behavior — has entered the gay lexicon.
Go on Grindr or Scruff in any large American city and see scores of queer people who say they take it on their profiles. Visit suburbs, small towns, and countrysides and see on the apps a few on PrEP there too — and the numbers are increasing everywhere.
Jason Orne, a sociologist at Drexel University, has identified two narratives from his current fieldwork with gay, bisexual, queer or same-gender-loving people who take PrEP in Philadelphia. “When we're talking about this ‘sexual revolution’ narrative, I think it's important to acknowledge that, sure, it may lead people to not use condoms — but also, great! This should be what we want, to help people experience sex without the fear of HIV.”
Even as PrEP is the closest humanity has yet come to a practical HIV vaccine, it is not widely taken. A 2016 demographic study estimated 4,503,080 American men have sex with men, and the CDC estimated in 2010 that well over 500,0000 MSM are HIV-positive. Last year, Gilead estimated that 136,000 Americans were taking Truvada for PrEP.
While the nationwide number of prescriptions for PrEP are rising, Gilead reports that those taking it are disproportionately white and over 90 percent are over the age of 25. Twelve percent of PrEP users are Latino and 10 percent are black; 24 percent of newly HIV-infected people are Latino and 44 percent are black. In 2015, the CDC reported that 22 percent of new infections occur in youth aged 13 to 24. While the FDA approved PrEP for adolescentslast year, Teen Vogue has written that stigma and parental consent laws have limited its use among young people.