Until recently, condoms were
considered the only viable option for safer sex practices among gay and
bisexual men. Once it was first discovered that HIV was a sexually transmitted
infection, condoms became the centerpiece of safe-sex culture. Although this
tool kept many gay and bisexual men HIV-negative through the worst of the
epidemic, but the use of condoms has dropped dramatically over the
years. Even among those most adherent, the use of condoms to prevent HIV has
often perpetuated an inequality among gay men; one that looks upon the
receiving partner in intercourse as more subservient. It's an inequality
apparent in the very terms we use: tops and bottoms. Tops are on top and
bottoms are on the bottom — not just in terms of sexual acts.
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, treated as though they were created
equally.
“I've
definitely felt belittled for identifying as a bottom. As if being a bottom
meant being something ‘less’ in our community,” said Joshua Collins, a PrEP
user from Phoenix, Arizona. “I also feel like we have certain expectations of
someone who identifies as a top and expect them to take control in sex. I've
definitely felt like the top was more in control within the sexual dynamic.”
A top is also
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.
As the bottom
partner, my HIV status was always contingent on someone else's decisions,” said
Damon Jacobs, founder of the popular Facebook group, PrEP Facts.
“I had to rely on the top to make sure the condom was used, or didn't fall off,
or didn't fall in, or didn't break, or didn't 'magically disappear' as condoms
sometimes do.”
A gay or
bisexual man who primarily tops is also less at-risk for HIV infection (but not immune). 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 the top 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, heterosexual sex, and pregnancy. 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 our HIV
status,” said Jacobs. “It allows both partners, in either sexual position, to
be 100 percent responsible for their pleasure and protection.”
Colton
Ferrell is a young PrEP user from Austin, Texas. He didn’t think too much about
the inequality of his preference for bottoming until he found himself in his
own sexual quandary.
“So, I never
really thought of there being an imbalance dependent upon sexual position,
until one time recently when the guy and I discussed using a condom,” said
Ferrell. “We agreed to use the condom, he grabbed the condom wrapper, I laid
down on my stomach, and we had — not so enjoyable — sex. Something, as a
bottom, I've noticed is that I can rarely feel the difference as to if the guy
is wearing a condom or not, and it turned out, that in this circumstance, he
wasn't, and he actually came inside of me. Aside from feeling very violated and
pissed, I was less worried than I feel I would've been, because I was on PrEP,
and wasn't as concerned about HIV, while still knowing I needed to get checked
for everything else.”
Ferrell’s
experience is just one example of how the one who is at risk is often left
without control in a situation of protection. 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 taking
responsibility for 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.
“I think I
can sum up how PrEP has changed the way I feel about sex in one word: wow!” said
Collins. “I've personally never been that adherent with condom usage and I
would always feel very guilty and irresponsible. I've had many a time I'd
nervously awaited an HIV test result hoping and praying. With PrEP, I don't
worry about it anymore and just enjoy the moment. Now I let my sexual partners
know I'm on PrEP and I've had some really great experiences with guys who are
positive and who I probably wouldn't have approached. I would say I'm a lot
more aware of my sexual health now because I get tested every three months.”
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.
“I'm a child
of the 1980s,” said Eric McCulley, a PrEP advocate. “And for the majority of my
life, all I've heard about sex is that it is dangerous and that it might
actually kill you. So it's nice to not be afraid of sex anymore. And to be in
control of my own sexual health is empowering and affirming.”
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.
No comments:
Post a Comment