A peculiar piece

There's an article at the New York Times written by a black gay man entitled My struggle to take Anti-Hiv medication.    I think people should find it odd.

First, there's no doubt that he's had much misfortune in his life:

My father was convicted of manslaughter and sent to prison in 1989, where he contracted H.I.V. No one in my family is exactly sure how. In 1991, six months after he returned home, he died. Less than two years later, my mother also died. I was only 7.

I don’t remember my parents in any great detail, but I do remember that people in our rural South Carolina community ostracized my sister and me once they learned our parents were H.I.V. positive. One parent even transferred her daughter out of my second-grade class.

He goes on to explain that he was put off asking for this HIV prophylactic drug by the first doctor he asked:

I was 27 when I first worked up the nerve to ask my doctor for a PrEP prescription. I was there for my fifth annual H.I.V. test, and I’ll never forget the look of disgust on her face as she told me why I wasn’t a candidate for the drug: I didn’t engage in “reckless sex” and I wasn’t a “druggie.” She was white and her tone was so thick with judgment that it made my skin crawl. I quickly dropped the subject. 

Five years later, with a more sympathetic doctor, he did go on it, but this is where it gets odd:

Instead of telling me why I wasn’t right for the drug, we spent the time talking about why I felt that I needed it. I had promised my parents that I would take every precaution against H.I.V., so I put enormous pressure on myself to take it. Plus, it let me be extra cautious about my health and my partner’s health. After our conversation, he tested me for H.I.V. and wrote me a prescription.

Promised his parents posthumously, I assume he means?  Anyway, having obtained the drug:

My first few weeks on PrEP, I felt fine. Every morning at 8 a.m. my cellphone chimed with a reminder for me to take my pill. I even began to develop a subtle sense of pride in knowing that although I was having sex only with my partner, I was upholding my word to my parents.

But as the one-month mark approached, I began to have serious doubts about why I was taking PrEP. After all, I wasn’t having sex with men other than my partner; same for him. We still used condoms, despite having been together for several years.

I recognize that PrEP is effective and agree that it should be available to people who want to take it. But after about a month of taking it off and on, I just stopped. I couldn’t get over the psychological barrier that somehow I was weakening my body by training myself to rely on pills. Instead, my partner and I decided to take the precautions we’re comfortable with.

Um, unless his partner was already HIV positive (or on medication for it), and this is never stated as being the case, the only implication seems to be that he took it because he cannot trust his partner to be true to his promise that he isn't sleeping around with other men.  Or, perhaps, that he couldn't keep his own promise to his partner - who he has been with for several years?

He points out that blacks have historical reasons to be wary of the medical establishment, and notes:

Retention rates for PrEP are deplorable — one study showed usage in Mississippi dropped by 15 percent over a three-month period — and it’s clear to me why. I had guilt and carried emotional baggage. I also felt alone in my journey. There was no PrEP community that I could find with which I could share my anxieties, no PrEP “sponsor” to call and discuss my night terrors or fatigue.

Is it possible that low retention rates indicate confidence that a partner found is HIV negative and faithful?   Not after 3 months, I guess.

Really, the article just seems to re-enforce something about the expectations of a gay lifestyle - that they have very low expectations of their partners - or themselves? - managing to have sexually exclusive relationships even if they promise to do so.

The conservative case for gay marriage is supposed to be about treating gay men similarly to how straight men behave - but honestly, how many heterosexual men (or women) have the expectation that they are at risk of contracting an STD from a steady girlfriend or boyfriend if they have started sleeping together (and assuming they don't have one from the start)?   Very, very few, I would say.   It's pretty much a natural expectation of fidelity that does not even need stating.  But in the gay community, it seems that it is quite the reverse, and few people think that is unreasonable.

The matter of exclusivity in relationships is one where a vast difference still lies between the heterosexual and homosexual communities.