Until recently, condoms were the only viable option for safe sex practices among gay and bisexual men.
When it was discovered that HIV was a sexually transmitted disease, condoms became the zeitgeist of safe-sex culture. Although this tool kept many gay and bisexual men HIV-negative through the worst of the epidemic, the use of condoms to prevent HIV created, or further perpetuated, rather, an inequality among gay men in their sexual relationships. Even within the gay community, the receiving partner in intercourse was looked upon as subservient and less than. In other words…
The tops had all the power.
Sure, many gay men often identify as versatile when questioned about sexual positioning. Even so, most usually have a general proclivity to one position or the other. Generally, some people are good at topping while others make for better bottoms. Yet, when it comes to mutual respect, sexual health, and protection, tops and bottoms aren’t, or weren’t always created equally.
A top is physically in control of wearing a condom. A bottom can only negotiate the use of a condom. You might think that this doesn’t necessarily create an inequity. After all, a bottom can walk away from a sexual encounter just as easily as a top. But in the throes of passion when the clothes are off and there are mere inches between “everything-but,” and full-on penetration, the power is greatly weighted in favor of the top.
A gay or bisexual man who primarily tops is less at-risk for HIV infection. But this is not the inequality that condoms create. A top who engages in condomless sex isn’t held nearly as responsible as a bottom often is when it comes to safe sex, yet it is the one who must physically wear the condom in question. The relationship between gay men, condoms and HIV can be directly paralleled with that of birth control and female inequality. And PrEP is to the empowered bottom the same way that birth control is to the empowered woman, including the slut shaming that both parties have often experienced as a result of their choice to take control of their health.
“PrEP is the first opportunity bottoms have ever had to be in full control of his HIV status. The use of Truvada as PrEP, the HIV prevention pill that is 99 percent effective at eliminating the risk of HIV infection when taken correctly, has the potential to revolutionize the gay sexual experience. Now, a bottom has the option to enter into the intercourse that he chooses with the knowledge that he has taken action to protect himself from HIV, regardless of the top’s preferences or agreements. Furthermore, he is involved in preventative care with his healthcare provider and engaged in his own sexual health.
But most importantly…
He is allowed to enjoy the pleasures of sex without experiencing any added shame for his preferred position or fear of a possible HIV infection.
So what does PrEP mean to the empowered bottom? It means living in an environment where the fight to stay sexually healthy is held on more of an equal playing field. It means less shame and fear and a greater sense of self worth and sexual pleasure.
As the arguments over the use of PrEP continue to dissipate and the science and validity of the HIV prevention pill continues to increasingly resonate within the gay community, it is now a matter of accessibility and affordability for those who need it so that more bottoms become empowered by the other little blue pill.
Here’s to a new kind of sexual revolution.