It’s Hard Out Here for a PrEP

It's the holidays and everything is awful, but the story of PrEP suggests it doesn't have to be. Sort of.

Some people call me Maurice, ’cause I’m the pompatus of love

Stephen Miller is that guy who would argue any point, no matter how repulsive, just to annoy people — because at some critical juncture early in life, he sensed that his only real angle was being hated by others, and he subsequently learned to get off on it.

Only your most annoying contrarian friend would argue that 2019 was a great year — only that guy, maybe, and Steve-o. Let’s not fool ourselves with rationalizations to make things seem better than they are, or simply to rally the troops. The clobbering of Labour in the 2019 UK election was a disaster of pretty historic proportions. The world continues to careen into climate catastrophe that is so obvious it’s practically banging on our bedroom window at 3am saying, “HELLLOOOOOOOO.” (Was this the “3am Summer” that Kamala Harris’s oafish campaign was nattering on about?) The very real possibility that Donald Trump will hold power for another five years is enough to chill the spinal fluid of any human with any sense whatsoever.

But there are still small blessings, and big ones. My generation has been able to come of age largely without the paralyzing fear of HIV, thanks to the extraordinary efforts of activists and scientists since the 1980s — to the point that HIV infections in some communities are now actually on the rise, thanks to complacency combined with lack of access to care and health education. The curious saga of PrEP or Truvada, a daily medication that proves highly effective in preventing HIV infection, illustrates the dilemma best. We have the ability to save everyone’s life from a sadistic scourge, but critics have long worried that PrEP will actually encourage risk-taking behavior by minimizing the fear of STD transmission — while America’s Kafkaesque healthcare and intellectual property systems, naturally, make the treatment difficult for many people to access.

However you slice it, the lesson of PrEP, as with climate change and so much else, is clear: we have the means to save ourselves, if we feel like it.

Here is a holiday season round-up of our best readings of the week.