The big double standard continues

This is topical - Trump talked about stopping HIV transmission in his State of the Union speech (something Conservatives commentary has made no mention of, as far as I have seen - no doubt because it hardly accords with their priorities).   Amusingly, I heard someone say that this idea appealed to Trump because he had so much feared catching it himself from his random sexual encounters in the AIDS heyday.   Sounds a very likely explanation.

Anyway, clearly a crucial tactic for this will be to increase use of PrEP, which allows users to greatly reduce any chance of catching it even with unsafe sex.

But, as I have written before, people do question the tactic if it's going to vastly increase the risk of other STDs spreading through the community.   This should be a particular concern when drug resistant strains of things like gonorrhoea are starting to really be a worry. This is the topic of an article in the New England Journal of Medicine, discussed here.

Generally speaking, it argues that doctors should not worry about the "risk compensation" rise of unsafe sex amongst those on PrEP.   But look at the reason given:

"PrEP does not protect against non-HIV sexually transmitted infections, but concerns about risk compensation do not justify withholding PrEP," said lead author Julia Marcus, Assistant Professor of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School. "According to the World Health Organization, sexual health is not only the absence of disease, but a holistic state of physical, emotional, mental, and social well-being in relation to sexuality. By enabling condomless sex with less fear of HIV transmission, PrEP has the potential to facilitate the intimacy and pleasure that can enhance sexual well-being for many people."

As the authors note, however, previous studies have suggested that clinicians may discount the importance of the psychological aspects of sexual health.

Look, the aspect of this that seems to be a case of self induced blindness when it comes  to considering gay folk is this:    no one is at risk of catching HIV if they are in a monogamous relationship with a HIV negative person.    But now the argument is that it's crucial to gay men's psychological sexual health to be able to have casual sex with men without a condom.

It is surely a clear case of a double standard here:    a straight man who picks up a woman at a club and has unprotected sex with her that night that results in pregnancy or an STD is going to be thought of at least as someone who made a mistake and let his libido override his common sense.

A straight man who for years goes out regularly and keeps sleeping with women he's just met without a condom is going to be thought of as really pretty dumb, and no one is going to be surprised if he catches a STD or ends up an unexpectedly father.

Surely doctors or friends knowing that's how he's living such a lifestyle are going to say "look, we know condoms don't feel great, but they are pretty reliable and it's not as if you are going to be using them the rest of your life.   If you get a proper girlfriend who you trust as monogamous, and you are too, and that she's using reliable contraception, then you can pretty safely drop the condoms."

How much freaking concern is a friend or doctor of such a straight young man going to have that telling him to use a condom is going to hurt his psychological sexual health?   I think we all know the answer - none whatsoever.

But with gay men, apparently they cannot be psychologically happy if they can't have condomless sex at any stage of their life in any circumstances.

I cannot get over the feeling that PrEP's widespread use is a form of too much indulgence of hedonism, and for just one sector of the community.