We need PrEP! And we need it now!

This is a transcript of the speech I gave at the EATG/AVAC conference on HIV Prevention in Brussels in January this year. There is a certain amount of overlap with my Qx article which I posted yesterday, but there are also some differences as the target audience was different. I thought it worth posting as I truly feel we need PrEP and we need it now. 

Speaking at the EATG/AVAC conference in Brussels

Good morning. First of all I should point out I am no expert, no scientist, no medical professional. I am just a participant in the PROUD study, and I’m here to talk initially about what being on PrEP has meant to me personally. I’ll then talk a bit about how people – friends, family, and the community in general – have reacted to the news that I am on PrEP.

I attend the Working Men’s Project at St Mary’s Hospital in London, which is a Sexual Health clinic for men who work in the sex industry. I suppose I should point out at this time that I was once an adult model and performer, and worked as an escort, and though I no longer do any of those things, I do, as a tantric masseur, still work on the peripheries of the industry, so I still go to the same clinic.

I tell you this to explain how I came to be offered the chance to become a participant in the PROUD study in the first place.  I had never even heard of PrEP until November of 2013, when one of the nurses at the WMP suggested it to me. I’ve always believed in total honesty about my sexual encounters when visiting a clinic, and, though I hadn’t realised it or admitted it to myself, it seemed my behaviour was becoming more risky, enough for me to fit into that at-risk group that would definitely benefit from taking PrEP.  After it was suggested to me, I first went away and discussed it with my best friend, who is positive, and on Truvada as one of his anti-retroviral drugs. I’d pretty much decided that I wanted to do the trial anyway, but it helped to talk it through with him. I then applied, was accepted and was delighted when I was put onto PrEP straight away, not into the deferred group that they had at that time. It was all very quick and I’ve now been on PrEP for over a year. I can honestly say I had no side effects, apart from some vivid dreams the first week or so.

Photo by www.mileselliotpictures.co.uk

Physically then, the effect was minimal, or negligible. But how about the psychological effects?

Well at first nothing much changed, but, as it gradually began to dawn on me, that I was protected from HIV, a cloud started to lift.

You see, I’m a product of the pre AIDS generation. When I came out there was no HIV, or at least we didn’t know about it. I’m one of the lucky ones. I didn’t die and I remained HIV negative, obviously or I wouldn’t be on PrEP. How I got here is no doubt down to a little judgement and a lot of luck, and I mean a lot of luck. Statistically I should be a statistic.

Back in the 80s the fear of AIDS stopped me having sex completely for quite a while. Fear of death does that to you and those were scary times. But once I did start having sex again, for the first time in my life, I started using condoms. I hated them. Sex didn’t feel so good anymore, but if you wanted to stay alive, there was no alternative. Sex had become a dangerous business. I mean people I knew were dying. If you didn’t see someone for a while, you hardly dared ask what might have happened to them.

I didn’t get tested. In those days a positive diagnosis was tantamount to a death sentence.  We were even told that the mere knowledge that one was positive could be enough to precipitate a downturn in one’s health. So I worried. I fretted.  I remember I panicked about it so much that at one point I even started suffering from night sweats. There was nothing wrong me.  And anyway, at that time, what was the point knowing?  But closing my mind off like that also meant that I remained ignorant of the advances in HIV treatments as they happened. Then, in 2001, a very close friend of mine died. He was admitted to hospital with pneumonia. He had never been tested for HIV and by the time pneumonia took hold he had no immune system left to fight the disease. He died soon after. If he’d only been tested and on treatment then he’d still be with us today. I got tested straight after my close friend’s funeral, and from that day on I became much more aware of my sexual health.

However, even after this, my adherence to safer sex started to falter. Not straight away of course, but little by little I was slipping. At first it was just what they call dipping, you know  when you just put it in for a few minutes without a condom, and think, oh well that doesn’t count. I’m not actually fucking. But actually it does. Then there would be other occasions when I wouldn’t use a condom at all. There would be discussion, risk assessment if you like, and I would decide to take the risk. It may have been calculated, but it was still a risk. And I found every sexual encounter was beginning to become a minefield. I was finding it harder and harder to use condoms. I’d lose my erection. I’d become so fixated on the  business of getting the packet open, and the bloody thing on, that I could barely think of anything else. They say condoms don’t have any side effects. Well isn’t erectile dysfunction a side effect?  I was beginning to give up the idea of penetrative sex altogether. So PrEP seemed like a miracle, and it has changed my sex life.

Mainly, and importantly, because it has removed anxiety. Gone. That’s it! I know I can’t get HIV. I know I can’t pass it on. For the best part of 30 years now, there was a voice whispering in my ear every time I had sex. “Be careful. You could get HIV.” And, you know what? That voice has gone. I can’t tell you how liberating that is. After years of worry about HIV, suddenly I don’t have to worry anymore. To me it was a no brainer. Short of a vaccine, this seemed to me to be the most important advance in HIV research since the discovery of anti-retroviral treatments for HIV positive people.

And because I felt so liberated, because I felt it was such an amazing breakthrough, I decided  I wanted to get the message out there, be totally honest about what I was doing, and extol  the virtues of PrEP. I thought that it would be greeted with open arms, and this is when I was surprised.

Now I have always been totally open about what I did and do for a living, which has given me a small amount of notoriety within the gay scene, and it is no doubt this notoriety which has enabled me to speak out about PrEP in the gay media and at certain gay events I’ve been invited to. In fact I have an article in this week’s Qx, one of the weekly London scene mags that you can pick up in any gay venue in London.

Going back a bit to July last year, an article written by one of my co-writers, appeared in TheGayUK condemning the use of PrEP. It was very negative and inaccurate on many points, and I decided I needed to retaliate with an article that got the facts right (Sheena was a great help here) and to shed a more positive light on PrEP. In my naivety, I expected people would be more open to it once they read the facts, but I actually ended up being on the receiving end of some pretty nasty comments. I’d worked in the sex industry for many years, but this was the first time I’d experienced real slut-shaming. I was called an irresponsible slut who didn’t give a damn about the sexual health of anyone else, which, considering the reason I was doing PrEP was precisely because I was concerned about my sexual health and that of those I was having sex with, was a little hurtful.

After I’d calmed down a bit from suffering those reactions, I started to look at the possible reasons for this negativity, for without understanding those reasons, we will  never be able to address them, or break down prejudices.

I questioned why the reactions of my family and straight friends were so positive, when those of some of my gay friends were not. Could it be that straight and gay people saw condom free sex in different ways?  For straight people, condom free sex was not just about pleasure, it was also about conceiving. It was about life. Whereas, for us, it had become associated with death.

Now a couple of weeks ago,  I saw a video of a speech by the magnificent Irish drag queen, Panty Bliss, which discusses the inherent homophobia that exists within our society, that homophobia which makes us ever alert, unable to make the slightest unconscious gesture of affection towards our partner without first checking our surroundings to see if it’s safe. He touches on the fact that we have become so used to this situation, that we have come to accept it as ok. He points out that this homophobia comes down to a basic distaste for what we do in bed, specifically anal sex, and that these homophobes, when they look at us don’t see a person, they just see a sex act.

And I think our problem lies in an internalised homophobia, which makes us ashamed of who we are, and, more importantly, ashamed of what we do in bed, particularly if we enjoy anal sex.

Let’s face it sex, any kind of sex, has long been about shame, unless it was to bring about a new life, which of course made gay sex more shameful still. There were those few hedonistic days when it finally became legal and the only risk gay sex carried was the possibility of picking up an easily treatable STD. Then AIDS came along. We had to deal with the shame of realising that our pleasure was killing us, that anal sex was one of the main transmission routes for this terrible virus. Worse still, the Reagan administration didn’t lift a finger to help us because it and a great swathe of America didn’t actually care that we were dying. That’s pretty hard to deal with.

Eventually, due to the efforts of campaigners like Peter Staley, we came up with drugs to keep us alive and  we discovered that we could save ourselves and our partners by wearing a condom, and the term safer sex was coined . And that’s when condom free sex became really shameful.

Now, for all the advances that have been made in recent years, for all the new therapies, the fact that we now know positive people with an undetectable viral load can’t pass on the virus, that shame about condom free anal sex still persists.

We feel shame about that time we were drunk or high and threw caution to the wind. We woke up the next morning and felt shame.

We felt shame about that time we realised we didn’t have any condoms but went ahead with it anyway.

We felt shame about that time the condom split but we kept going because it felt so much better, and, here’s the thing, we felt really ashamed about admitting, even to ourselves, that one fact. Sex without condoms feels better. There I’ve said it. And apparently I’m not alone, as the majority of people on the PROUD study gave the reason that “it felt better” as the main one for having condom free sex. Not being high or drunk.

Such is the shame about condom free sex, that we even coined a new word for it, a loaded word that carried with it a sense of risk. Barebacking. And more and more people were willing to take the risk. We might not actually want to get HIV, but at least we now weren’t going to die if we did.

Now I wish we could get rid of that word “barebacking”, banish it from our vocabulary, because barebacking when you’re protected isn’t risky, or shameful, it’s just natural.

That said, I understand why it’s going to take some time for that message to get through, and it’s only by people like me being up front and talking about it that the message will get through.

I think I’ve probably now heard every argument imaginable against PrEP, and most, to be honest,  are just side issues, but the one I hear most often is that it will encourage promiscuity, which was exactly the main objection to the birth control pill for women back in the 60s. Well we were able to get over that problem, and the birth control pill is now, in the west at least, the most commonly used form of contraception for the majority of women, mostly because they were able to take control of their own sex life.

And this is the point about PrEP. It puts me in control. I don’t have to worry about whether a partner is telling me the truth about their status. I take my pill every day and I know I’m protected. Just as women knew when they took their pill every day that they couldn’t become pregnant.

This is the good news we need to give MSM. That PrEP allows us to take control of our own sexual health. PrEP can eliminate the difference between positive and negative and we can become a community that is no longer split by our HIV status.

Quite the opposite of being irresponsible, PrEP is taking responsibility for our own health, and those with whom we have sex. That’s why we need PrEP – and we need it now!

#Truvadawhore

This article is a potted version of a speech I did for Pat Cash's Let's Talk About Gay Sex & Drugs back in December 2014. It was published in Qx Magazine on 22 January 2015

Photo by Miles Elliot

I’m Greg Mitchell and I’m a Truvadawhore. I take one pill a day (Truvada) and that stops me getting HIV. It’s called PrEP (Pre-Exposure Prophylaxis). However some in the gay community think taking PrEP makes me a bad person; irresponsible, a slut, a whore.

I’m a product of the pre AIDS generation. I remember a time when there was no HIV. Somehow I survived the worst of the AIDS epidemic and I’m still HIV negative. How I got here is no doubt down to a little judgement and a lot of luck. Statistically I should be a statistic.

Back in the 80s the fear of AIDS, well the fear of death, stopped me having sex completely for quite a while. But the sexual imperative is a strong urge, and eventually I started again. I used condoms, I hated them, but the alternative was too horrible to contemplate. Sex could still be good, but it wasn’t the same. 

However, with the advances in HIV treatment, I’ll admit my adherence to safer sex started to falter. At first it was just what they call “dipping”: when you just put it in for a few minutes without a condom, and think, “that doesn’t count. I’m not actually fucking”. Then there were other occasions when I wouldn’t use a condom at all. There would be discussion, risk assessment if you like, and I would decide to take the risk.

I was finding it harder and harder to use condoms. I’d lose my erection. I’d become so fixated on the  business of getting the packet open, and the bloody thing on, that I could barely think of anything else. I was beginning to give up the idea of penetrative sex altogether. So PrEP seemed like a miracle, and it has changed my sex life.

Because it has removed anxiety. I know I can’t get HIV. I know I can’t pass it on. That is a liberating feeling.  Short of a vaccine, I thought it the most important advance in HIV research since the discovery of anti-retroviral treatments for HIV positive people. My family and my straight friends agreed, so I was astonished to find that many in the gay community were less enthusiastic. Why?

Ultimately I think some of the negative reactions come down to shame. Gay sex, any gay sex, has long been about shame. It wasn’t that long ago that it became decriminalised here and in most Western countries (in fact it was still illegal when I was growing up), and in 81 countries around the world it is still against the law. Then in the 1980s it became even  more shameful as we discovered it was one of the transmission routes for a deadly disease.

Before that time condoms were for preventing babies. No gay man would ever consider using one, but, as our brothers started to die around us, we realised it was either put a rubber on it or become another statistic.

And that’s’ when condom free sex became shameful. We even coined a new word for it, a loaded word that carried with it a sense of risk. Barebacking. More and more porn was bareback, revelling in its risky nature. New treatments meant that HIV was no longer deemed a death sentence. Still, I’ll wager most of the people indulging in occasional condom free sex end up feeling guilty for ages afterwards, hoping against hope that when they next test they will be ok. But that probably starts a pattern. Once you get away with unsafe sex, you try again and again, until one day you go for that test and it comes back positive.

I am also convinced that many of those who condemn the use of PrEP are under the misapprehension that those gay men testing positive are just the dirty gay guys, the ones who go to weekend sex parties and take lots of drugs, and no doubt there is an undercurrent of feeling that they deserve it. People get sorted into the good gays and the bad ones. Good gay guys subscribe to the hetero-norm, they meet the man of their dreams and settle down in a monogamous relationship, while the bad ones have multiple partners and go to cruise bars and sex clubs.

But many of these good gays, the ones with boyfriends, the ones who think they are in monogamous relationships, are still testing positive. In fact more than half of all new HIV cases come from the primary partner. Maybe some of these good gays are not as good as they like to think they are; maybe we should stop condemning people who choose a different life style from our own; maybe we should all stop being so damn judgemental. Because PrEP can eliminate the difference between negative and positive. We can become a community that is no longer split by our HIV status.

Quite the opposite of being irresponsible, PrEP is taking responsibility for my own health and the health of those I have sex with. If that makes me a Truvadawhore, then so be it.

Speaking at Let's Talk About Gay Sex & Drugs - December 2014

The Curing Room at the Pleasance Theatre, London

“It made the recent Globe production of Titus Andronicus look like a teddy bear’s picnic!” said my companion, as the lights went down on Stripped Down Production's The Curing Room.And indeed over 90 minutes we had been subjected to a deluge of blood, guts and gore, coupled with full frontal male nudity the likes of which I have never seen before on the stage.

David Ian Lee’s  The Curing Room throws seven Soviet soldiers into the empty cellar of  a monastery, stripped of all belongings and their clothes. Abandoned by their captors, and left without food, the men resort finally to murder and cannibalism in order to survive. The play asks questions about how we redefine ourselves in extreme circumstances, how the constraints of normal civilised society and military rank cling to us, or don’t.

The play is something of a tour de force for the seven brilliant actors, who literally bare all before the  audience. Director Joao De Sousa is unflinching in his depiction of cannibalism and there is, as I said earlier, a lot of blood. My companion spent much of the latter part of the evening with his head turned away from the stage.  This play is definitely not for the faint-hearted, and if your only reason for going is a prurient desire to see seven men naked, well you soon get used to that. The gore is harder to cope with.

It would be invidious to pick out any one of the actors. They all work as a close knit team, and all, without exception give excellent performances. De Sousa’s pacing is brilliant, and I was gripped throughout. Once away from the theatrical brilliance of it all, though, a few minor doubts crept in about the writing and about the play itself. For much of the play, the characters come across as mere cyphers, as representatives of certain types; the stiff upper lip captain, the honourable senior-lieutenant, the slightly simple young private, the old retainer and so on. This could be the reason I found it ultimately less involving than I should have. Though the horror of what unfolds before you certainly draws you in,  ultimately ones cares little about the fate of these soldiers as individuals.

None the less, The Curing Room is gripping drama and well worth seeing if you have the stomach for it. I doubt we will see anything like it again for some time.

4 stars

The Curing Room is at the Pleasance Theatre until November 9^th.

So Why Are So Many Gay Men Opposed to Prep?

This article was first published on TheGayUK a week ago, and I have to say I have been astonished and saddened by some of the negative and downright vitriolic responses I have received. I had not realised till then how polarised the gay community is regarding HIV, and how the disease is still stigmatised and discriminated against within our own community. In the constant battle against HIV and AIDS, how anybody can see the discovery of PrEP as anything but a good thing is completely and utterly beyond me. 

So why are so many gay men adamantly opposed to PrEP, the daily dose of the anti-retroviral drug Truvada, which is at least 90% effective at protecting against HIV? Indeed, according to a recent iPrEx open-label extension (iPrEx OLE), to date the largest demonstration project of HIV Pre-Exposure Prophylaxis, daily taking of Truvada could be as  much as 99% effective.

This is a question I’ve been asking myself quite a lot recently, especially after reading some negative  articles in the press and one, by Joshua Vaughan here in TheGayUK a couple of weeks ago, which was actually inaccurate on several points.

About nine months ago, the GUM clinic I regularly attend (the Working Men’s Project at St Mary’s in Paddington) offered me the chance to be part of the PROUD study, which examines the impact on gay men of using Pre-Exposure Prophylaxis (PrEP), and I jumped at the chance, not only because I wanted to do my bit for the community, but because it offered me an extra level of protection against HIV, regardless of whether I was using condoms or not.

Before moving on to the whys, let me tackle some of the issues and downright inaccuracies in Vaughan’s article. Rather than rely on hearsay and prejudice, I spoke to Professor Sheena McCormack, the lead doctor for the PROUD study, who is also Consultant Physician at 56 Dean Street.

Vaughan states that there has been a significant drop in HIV transmission rates between 2001 and 2012, but though this is true globally, there has been no drop in the rates amongst gay men, and there is evidence to suggest that, on the contrary, they are rising. This may have something to do with an increase in the number of gay men presenting themselves for testing, but it is worrying none the less. Vaughan also enumerates at length the terrible side effects which can accompany the taking of Truvada, but fails to mention that those that suffer these side effects constitute only a small proportion of those taking the drug. A recent large study of over 4000 HIV negative men and women in Kenya and Uganda, found that there were very few significant differences when compared to placebo, and only a minority (less than 10%) of HIV positive people taking it in combination with a third drug discontinue because of side effects due to Truvada . Anyone taking Truvada for PrEP who suffers side effects can simply stop taking it, but so far, according to Professor McCormack, only one person has stopped because of problems with the medication.

Vaughan states “The WHO believe that medicating ALL homosexual men will provide an additional method of preventing infection. Along with condom use and regular testing. But activists have suggested that introducing government mandated antiretroviral would discourage the use of condoms, currently the best method to prevent the transmission of sexually transmitted infections. Resulting in an increase of other sexually transmitted infections such as gonorrhea, chlamydia and hepatitis in the gay community.” First of all, the WHO is not saying that all gay men should be given PrEP, but that they should be offered it, which is slightly different. Nor has any of the data surrounding possible increases in other sexually transmitted diseases been analysed yet, though the Partners PrEP study suggested no significant change in behaviour.

Regarding the cost, I have no idea from where Vaughan plucks his figure of £10,000 per person per year, but Professor McCormack assures me this is far beyond the mark. Though it would be difficult to put an exact figure on it, because of the National Health’s buying power and their ability to get large discounts, the figure is more likely to be in the range of £5,000. Already it is being offered in the private sector for around £500 per month. He says this is a lot of money to spend on a preventable disease, but that is exactly what the medication is for, and, with a 90% (and possibly even a 99%) success rate, it actually makes it more successful than condoms.

To quote from a United States C.D.C. study of 2013, “We are also unclear about to what extent condoms actually prevent HIV transmission in anal sex. This last fact may seem surprising, given that condoms have been recommended since the mid-1980s as the only effective HIV prevention method for gay men who have anal sex. In fact, there is only one large study in gay men, dating from 1989. In this study of 2914 gay men, HIV incidence among those who said they used condoms 100% of the time was 70% lower than in men who did not use them at all. There has been one small study in the era of antiretroviral treatment (ART), which found an efficacy of approximately 75%.”

Vaughan states that introducing the drugs could run the risk of the virus evolving immunity to the drug, but this is in fact only likely in cases where a participant is seroconverting when they start taking the medication. It can also be a problem for HIV positive people who have a gap in their treatment, this being a particular problem in parts of Africa where people have to travel miles to get their medication and end up missing doses.

So, given so many positives, how can offering PrEP be a bad thing, and why is there so much resistance within the gay community? Professor McCormack is mystified. “This is a good thing,” she tells me, adding that most of her colleagues that work in Sub-Saharan Africa (who are friends and mainly female and straight!) queried why WHO did not specifically mention women in the recent consolidated guidance. And indeed we ought not to ignore the needs of other communities that have been shown to benefit from PrEP, including intravenous drug users, and heterosexual men and women.

We can bang on as much as we like about better, more targeted sex education in schools, but there is little to suggest it would have a major impact on the epidemic. It has had little effect on unwanted pregnancies, even though no-one leaves school without knowing where to go for contraception. It may be that the UK’s problems come down to an age-old embarrassment about talking about sex. In countries like the Netherlands and Scandinavia, where they have traditionally been more open and matter of fact about sex, teenage pregnancies and STD infection rates amongst young people are far lower. The problem could be more cultural than anything else.

Coincidentally, I think that most of the resistance to PrEP boils down to shame about admitting to enjoying condom free sex. In the study on condom use cited above that figure of 70% was amongst gay men who said they used condoms 100% of the time. My italics. How many of those were actually lying, or conveniently forgetting that time when the condom broke, or they indulged in dipping, or actually didn’t use a condom at all because they were drunk or high?

Gay sex itself has been about shame for a long time. It wasn’t that long ago that it became decriminalised here and in most Western countries, and in many countries around the world it is still against the law. After it was decriminalised, there was a brief period when gay sex was fun and the only risk it carried was the possibility of picking up an easily treatable STD. Then in the 1980s it became shameful again as we discovered it was one of the transmission routes for a deadly disease. Many people died because of it, and it took a lot of time, and a lot of campaigning, for gay men to take on the safer sex message. Before that time condoms were for preventing babies tout court. No gay man would ever consider using one, but, as our brothers started to die around us, we realised it was either put a rubber on it or become another statistic. Gay sex was shameful again. The advice was cut down on partners, use condoms or die. I remember for a few years I pretty much gave up sex altogether, with or without condoms.

Then the new combination treatments came along and people began to survive, though many of those first drugs had some pretty terrible side effects. But the advances in the last 10 years or so have been immeasurable. People don’t die anymore. Nor do the new treatments have such terrible consequences. People with HIV can now live a normal life. What’s more, whereas once it was deemed better to hold off treatment as long as possible, because of the toxicity of the drugs, now it is better to get people onto therapy as soon as possible as the therapy quickly brings down their viral load to undetectable, which means they cannot pass on the virus.

It is of course quite possible that the fact that we are no longer seeing people suffering or dying around us had made us complacent, and this could be the reason we are seeing higher rates of HIV incidence amongst gay men. I’ll admit it; I was taking the odd risk that I wouldn’t have taken even 5 years ago. It may have been a calculated risk, but it was a risk nonetheless.

Why take the risk at all, you might ask. Well, because I don’t like condoms. For years I have been having sex and not really enjoying it because I have had to use a condom. But even on those occasions I took a calculated risk, enjoyment was difficult because there was always a doubt at the back of my mind. We may have discussed it, but how sure were we? Could I, or the person I was with, actually unknowingly have the virus and pass it on? We may have both tested negative recently, but how sure were we? And so on.

Two years ago I wrote an article condemning the indiscriminate practice of barebacking, but the landscape has changed completely since then. There is still much in that article I agree with, and I have not ditched the condoms altogether. I rarely fuck or get fucked at a sex club, but if I did I would still use a condom. Though, pre-AIDS, I would never have dreamed of using condoms, I would only now go bareback with someone I had a more intimate relationship with. What PrEP does is it removes that lingering anxiety, and how liberating that is.

I’ll give you an example. A couple of days ago I had sex with a guy I have known now for about a year, a fuck buddy rather than a relationship if you want to put a label on it (I don’t). We have always used condoms before, even though we are both sure we are negative. On this occasion we didn’t, and the knowledge that I am on PrEP allowed us to have the kind of joyful, unbridled pleasure in each other that we had both forgotten existed, in the sure knowledge that neither of us could give each other HIV. That is a liberating experience, yet the moral police out there, would prefer that we didn’t have it. After all, gay sex is shameful, isn’t it? And condom free gay sex is even more shameful.

I am convinced that many of those that are condemning the introduction of PrEP are also under the misapprehension that those gay men testing positive are just the dirty gay guys, the ones who go to weekend sex parties and take lots of drugs, and no doubt there is an undercurrent of feeling that they deserve it. (I don’t agree, by the way). Indeed only recently, former gay soldier James Wharton (one of the good gays) recommended closing down gay saunas, with the outrageous claim that they were standing in the way of equality and were breeding grounds for drugs and HIV. Good gay guys subscribe to the hetero-norm, they meet the man of their dreams and settle down in a monogamous relationship. But it would seem that many of these good gays, the ones with boyfriends, the ones who think they are in monogamous relationships, are still testing positive. Maybe some of these good gays are not as good as they like to think they are; maybe we should all stop being so damn judgemental; and maybe we should just welcome the advances in medical science that have brought us PrEP.

There can be little doubt that much of the debate surrounding PrEP has been couched in moral terms. Only recently Michael Weinstein, the CEO and President of the AIDS Healthcare Foundation poured considerable funds into fighting its approval and went as far as calling Truvada a “party drug”, an outrageous comment on a drug that can help prevent transmission of the virus to a wide range of people, including gay men, sex workers and HIV-negative individuals in relationships with people living with HIV. A petition has been started to have him removed from office for trying to block one of the most revolutionary developments in the history of the AIDS epidemic. To quote Eric Paul Leue, Mr Los Angeles Leather 2014, who started the petition,

“This petition is about whether we, the people, should be allowed access to accurate information, free of stigma and discrimination. Since 1980, HIV and its prevention has been framed in moral terms, and the people carrying the virus blamed. The head of our largest AIDS service organization should know that HIV prevention is not “a party.””

PrEP is not widely available in the UK yet, but the PROUD study, of which I am a part, could result in it being offered to gay men more widely; offered to them, not forced on them. Isn’t it always better to have choices? If I am offered the chance of an extra level of protection against HIV, why should I be judged for accepting it? My body, my choice.

Professor McCormack has written a little poem about the benefits of PrEP, and performs it here on this youtube clip.

BFI Flare 2014 - Movie Reviews

So it’s almost two weeks now  since the brilliant 52 Tuesdays closed BFI Flare 2014 (formerly the London LGBT Film Fesival) and what a festival it was, showing a range of shorts and documentaries, at least 50 feature films from all over the world, and a series of interactive media events.

I managed to get to see 10 of the films that were showing, though there were plenty of others I’d have liked to have seen, had I had the time.

First and foremost was the film chosen to open the festival.  Lilting is a gently moving piece about bereavement, grief and colliding cultures, beautifully scripted and played and directed with a sure hand by Hong Khaou. The way in which he dovetails past and present, real and imaginary, whilst making sure the movie flows seamlessly was really quite special. He was immeasurably helped by some superb performances, especially Ben Wishaw’s deeply broken Richard, reeling from the recent loss of his boyfriend Kai, a performance superbly seconded by Cheng Pei Pei, as Kai’s mother Junn, a Chinese-Cambodian woman who has never come to terms with the English world she was thrust into. She has never learned to speak English and Kai was her only connection with the alien world she finds herself in. Despite their closeness Kai had never felt it possible to come out to her, leaving Richard with the impossible task of wanting to do right by his lover’s mother without divulging the true nature of their relationship. Wonderful supporting performances too from Andrew Leung as Kai. Peter Bowles as the Englishman Junn befriends in the home she is living in, and Naomi Christie as Vann, the translator Richard employs for Junn. Subtle, poetic, almost unbearably moving without being mawkish, this is a must see. (5 stars)

Pierre-Gabriel Lajoie and Walter Borden in Gerontophilia

Toronto based filmmaker Bruce LaBruce is no stranger to controversy, and so it is that, in his latest movie, Gerontophilia, he turns to the subject of age gap relationships, which, according to LaBruce transgress a very strong cultural taboo. Lake is an unusual young man with an unusual fetish. Though he has a girlfriend, he is attracted to old men, a fetish he gets the chance to pursue when he starts a job as an orderly in an old people’s home. Whilst in the home, he is appalled at the way the inmates are treated and strikes up a relationship with Mr Peabody, weaning him off the medication that keeps him easy to manage, and eventually helping him to escape so they can set-off on a road-trip together. So far, so good, but for me the problem at the heart of the movie was that the central relationship between Lake and Mr Peabody didn’t really ring true. Maybe Pierre-Gabriel Lajoie had been encouraged to play Lake with a sort of wide-eyed innocence throughout, but it made it hard to believe that there was a strong sexual bond between the two men. However, with the veteran Walter Borden putting in a wittily amusing performance as Mr Peabody, it is a very enjoyable film, as much about how modern society responds to old age as it is about age-gap relationships. (3 stars)

Age and aging were some of the concerns of Rosie, a Swiss film, directed by Marcel Gisler, in which gay writer Lorenz and his sister Sophie squabble and ultimately reconcile about what to do with their aging alcoholic mother, Rosie, splendidly played by Sybille Brunner. Plenty of family skeletons fall out of the cupboard as Lorenz tries to get to the bottom of the rift that existed between his mother and father, a rift that coloured his and his sister’s childhood. A touching and eventually uplifting movie about family with a sly, gentle humour. (4 stars)

Providing quite a contrast to these was Charles Lunn and Todd Verrow’s documentary Age of Consent, which tells the story of The Hoist, one of London’s few remaining leather bars, which opened in 1996. It being the story of a sex club, we get to see plenty of sex, some of it quite graphic. Ultimately, though, it turns out to be not only a fascinating glimpse into London’s leather scene, but a history of gay sex since decriminalisation. Did you know, for instance, that there were more convictions for gross indecency in 1989 than there were in 1966, the year before homosexuality was made legal for “consenting men in private”? The “in private” part was something the police vigorously enforced it would seem, often using pretty policeman to entrap gay men and secure a conviction. Against a backdrop of leather men grunting and groaning with pleasure, Peter Tatchell talks eloquently, as ever, about the continuing battle for equality under the law; co-owners Kurt Striegler and Guy Irwin tell us all about how the club got started., and some of its regulars tell us what makes the club special for them. There are no doubt those amongst the gay community (like James Wharton who was only recently proposing the closure of all gay saunas) who will find the goings on in the club quite disgusting, but surely the point is that we should all have equality before the law, whatever our sexual preferences, a fact that was brought brilliantly home by this excellent documentary. I do hope it gets an official release. (4 stars)

Also receiving its first London showing was a Cuban film La Partida (The Last Match), directed by Antonio Hens. This is a bleak tale of young men from the slums in Havana. Though many of these young men identify as straight, it appears there is no shame in befriending and having sex with older rich tourists for money. Rather than being the exception it is the norm, and the women know and accept what is going on. Yossani and Rey are friends, playing on the same local football team, but they find themselves becoming physically and emotionally drawn to each other with typically tragic results. Though men having sex with others for money is accepted, two men in love is not. The two young actors Milton Garcia and Reinier Diaz give great performances in this brutally realistic drama. (3 stars)

You can find reviews of some of the others I saw in TheGayUK’s archives, but it was good to be reminded of Michael Douglas’s Emmy award winning performance as Liberace in Behind the Candelabra, the delightfully amusing G.B.F., the mesmerising thriller Stranger By The Lake, and the harrowingly moving documentary Bridegroom.

The festival ended on a high note with an Australian movie (directed by Sophie Hyde) called 52 Tuesdays, a remarkable movie about a woman, Jane (Del Herbert-Jane) who, having put it off for years, is finally going to transition from female to male. James decides that to do so he needs some ‘me time’ so suggests that his daughter Billie (Tilda Cobham-Harvey) goes to live with her father for a year. They make a pact that they will meet every Tuesday. Seen mostly from the point of view of Billie (a blisteringly brilliant debut from Cobham-Harvey), we go through every painful moment of James’s process and Billie’s difficulties in understanding and coming to terms with what is happening to her mother, meaning that Jane’s transition to James is set against Billie’s transition from child to adult.  The physical facts of hormone treatments and surgery Billie finds relatively easy to deal with, the emotional changes are more complex and more confusing. Shot over 52 actual Tuesdays, the non-professional cast were given their scripts a week at a time and only saw the scenes they were actually in. This unique and original drama deservedly won Sophie Hyde a best director award at Sundance, and brought what had been a great event to a fitting close. (5 stars)

My Little List

This is a slightly expanded version of an article I wrote for TheGayUK, which appears in their latest downloadable version; expanded because, since I wrote it, a few more names have come forward, who unquestionably deserve to make this distinguished list.

Warning. This article may cause offense. Sorry about that, but the people listed below have caused me plenty of offense over the years. It’s payback time.

“As some day it may happen that a victim must be found,
I've got a little list — I've got a little list
Of society offenders who might well be underground,
And who never would be missed — who never would be missed!”

The words are Ko-Ko’s in Gilbert and Sullivan’s The Mikado, but if only I too could be Lord High Executioner, just for a day. I’ve got my own little list of society offenders who never would be missed. 

Peter Hitchens

Take Peter Hitchens for instance. Does it never bother him that people look at him and wonder why the wrong brother had to die? Presumably not, because nothing ever seems to knock that smug, self-satisfied expression off his face. Much of my dislike of the man, I’ll admit, is an irrational reaction to both his face and his pompous voice, and there have been (very rare) occasions when I’ve actually agreed with something he’s said. Even so, I always feel I want to hit him. When he’s on Question Time, it’s all I can do to stop myself launching a brick at the television. Sorry, but there it is.

Talk of Peter Hitchens, brings me to quite a few other Daily Mail columnists and the editor himself, that “frothing autocrat”, to use Stephen Fry’s phrase, Paul Dacre, one of the nastiest individuals I’ve ever come across. I’ll let the estimable Mr Fry sum up my feelings about  him. 

Dacre is, all those who have had the misfortune to work for him assure me, just about as loathsome, self-regarding, morally putrid, vengeful and disgusting a man as it possible to be. His power is absolute. Cross him either in private or public and you will be assassinated by his sycophantic squad of columnist minions, all of them infected with his brand of repulsive hypocritical and gleeful spite, ready to vomit out a screed against the BBC or any other institution they hate.

Paul Dacre

Dacre and his rag had another go at the estimable Mr Fry after his, as always, brilliant hosting of the 2014 BAFTAs.  Petty stuff and not even worth repeating, but Dacre definitely goes on the list. I’ll even let you pull the trigger, Stephen. 

So that you won’t feel too lonely when they march you out to stand against that wall, Mr Dacre, maybe we could surround you with a few friends; Melanie Phillips, a sort of female Peter Hitchens, only not as womanly; that stupid woman Jan Moir, who started banging on about Stephen Gately’s “gay lifestyle” being responsible for his death, before his family had had a chance to even deal with the shock, and making wild assumptions before the cause of death had been established (a pulmonary edema resulting from an undiagnosed heart condition, as it turned out); the loathsome Richard Littlejohn who outed transgender teacher Lesley Meadows, in a nasty transphobic piece, that no doubt contributed to her suicide. Neither Moir nor Littlejohn ever apologised, but that is the way with the Daily Mail. What’s a life when there’s a good story at stake? What indeed? Line them up.

While I’m at it, maybe I can take steps to burn all copies of the Daily Mail, burn down their printing press and offices, and literally do everything possible to prevent it ever being printed again. I doubt it would be missed, and maybe “outraged of middle England” might actually end up feeling a little happier, and even a little less outraged.

Vladimir Putin

Time now to look further afield and outside the UK. First and foremost would have to be Vladimir Putin, that confused despot, who doesn’t know the difference between homosexuality and paedophilia, but delights in posing for homoerotic photographs. Poor man obviously has quite a few self-esteem issues, as he regularly apes the Red Queen from Alice in Wonderland, screaming “Off with his head” at anyone brave enough to contradict him. 

Vitaly Milonov

Next to him we’ll put Vitaly Molonov, one of the architects of the present ant-gay law in Russia, who seems to equate homosexuality with bestiality, and proclaims he is only doing God’s work (we’ll get on to religion in a moment). He is convinced that homosexuality is a choice, though one wonders why anyone in their right mind would make such a choice in a country where they are likely to be beaten up, or even killed. The man is clearly mad. Only recently he has proposed granting full citizenship to embryos and forcing women who have not given birth by the age of 23 to join the army. Eh? “Off with his head!”

After the recent screening of the deeply disturbing and desperately sad documentary “Hunted” from Channel 4’s Dispatches team, I’ll also add Timur Islav, a self-styled vigilante and member of Parents of Russia, and the vile Ekaterina Zigunova of the group Occupy Paedophilia (yet again Russians make no distinction between homosexuality and paedophilia) who cheerfully explains to the Dispatches team how she plans to ruin the lives of any gay man who comes within her radar. After the documentary aired on February 5^th, there cannot have been a gay man anywhere in the UK, who did not wish her dead. You know, all that pleasure you take in torturing young gay men, and in ruining their lives, Katya? Well you can’t begin to imagine what pleasure I’d take in marching you out in front of a firing squad of gay men. I’m sure they’d like to hurt and humiliate you a bit first, just so you know what it’s like. 

Ehaterina Ziganova

And so I move on to religion, or rather those who commit crimes of hatred in its name. Truth to tell, there are rather too many of them to put in front of a firing squad. It would be a very crowded wall and you might miss one or two, so I prefer to take a few examples and make them scapegoats. After all, scapegoating is something these nasties are all rather good at.

Joseph Ratzinger

Now I know he doesn’t really pose any kind of threat anymore, not since he was ousted, I’m sorry, I meant since he stepped down (the first Pope to resign since 1415!), but Joseph Ratzinger shouldn’t really be allowed to get away with years of shielding paedophile priests, with subjecting women in poor countries to the servitude of continuous motherhood, with furthering the spread of HIV by not allowing people to use condoms. There’s no way he should be holed up in comfort somewhere in the Vatican City, safe from the clutches of journalists. He should be out to face his crimes.

Talk of Ratzinger reminds me that it was he who gave his blessing to Rebecca Kadaga, the Speaker of the Ugandan Parliament, who promised to pass the notorious Ugandan “Kill the Gays” bill as a “Christmas gift”. She should not go unpunished.

Goodluck Jonathan

Nor should Goodluck Jonathan, Nigeria’s president, who has just passed a “Jail the Gays” law, which is already spreading untold misery for anyone who is, or is even suspected of being, gay. “One of the most dangerous anti-LGBT leaders that we have in the world today,” according to Chad Griffin of the Human Rights Campaign, we should just do the world a favour and add him to the list. He certainly won’t be missed.

Peter LaBarbera

Scott Lively

Only yesterday two long-time opponents of the U.S. Gay Rights movement announced a coalition that will seek to persuade more countries around the world to follow Russia’s example in passing laws that restrict gay rights. The pressure they are exerting has already worked in countries like Uganda and Nigeria and is spreading like a cancer throughout Africa. The coalition consists of Massachusetts based evangelical lawyer Scott Lively, and Peter LaBarbera of Americans for Truth About Homosexuality, which does the exact reverse of what it says on the packet, delighting in unsubstantiated “facts” and un-truths. Feeling that they have lost the battle in the US and Europe, they are taking their hatred  to third world countries, where lack of education and ignorance prevails, their mission to encourage allies abroad to lobby their own governments and follow Russia’s example.  Would they really be missed?

 Back in the UK, some of you may not yet be aware of the name of Andrea Minichiello Williams, a UK Evangelist who recently travelled to Jamaica to urge their government to keep the law that criminalises homosexuality. She links Tom Daly’s recent coming out about his sexuality to the death of his father and, like the Russians, still insists there is a link between homosexuality and paedophilia, despite compelling evidence to the contrary. She is strongly opposed to a bill at present going through parliament that seeks to ban gay-to-straight conversion therapy. Apparently it is the government that lacks compassion, not her radical Christian Concern charity, though why it has maintained its charitable status is beyond me. There is nothing charitable about it. She’s been a little quiet over the last month or so, but I’m sure she has some other dastardly scheme up her sleeve. Society offender? Absolutely.

Andrea Minichiello Williams

And so finally I come to all those religious extremists, most with names too long and complicated to remember. Zealots one and all, the problem with this lot is that you no sooner get rid of one, than another pops up somewhere else. Far more dangerous than any of those I’ve mentioned by name, they’re pretty indiscriminate about whom they kill in their quest for world dominance. Flying planes into tall buildings and blowing up buses and tube stations means you’re probably going to kill quite a few innocent people of all faiths, including your own, but that is just considered damage waiver. What on earth do we do about this lot? I must admit they have me stumped.

Of course one solution might be just to line all Gods up in front of the firing squad. That they may not themselves be responsible for the atrocities continually committed in their name, is very true, but you have to admit that they’re not really doing much to stop them. Then of course there is another problem here. None of these Gods actually exist, so how on earth am I supposed to find them.

I have no doubt that some of the above mentioned will have their own little lists, and I also have no doubt, that in the extremely unlikely event that any of them had even heard of me, I would figure high on those lists. The worrying thing is that, though my list might merely be a bit of harmless fun, I feel sure that they, with the possible exception of the Daily Mail columnists, would have no compunction about slaughtering all the people on their little lists, and would probably glory in doing so. It’s what they do. Whereas I, a self-proclaimed atheist and humanist, have never willingly or wilfully done anything that might harm another human being, most of those above do, and are doing so on a daily basis. Think of that, if you’ve got this far and find you’re a little offended. Well I did warn you.