“You take the blue pill, the story ends. You wake up in your bed and believe whatever you want to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes.” — Morpheus, from the 1999 movie “The Matrix.”
Almost three years ago, I chose to take a blue pill every morning. If you reverse the colors above, choosing the blue pill was my decision to see where the rabbit hole goes. What is the red pill option in my inverted analogy? Living in the shadow of HIV.
HIV. Such a loaded word. Dirty. Disease. Terminal. Gay cancer. Sexually transmitted. I’m sure you can think of other descriptors.
Before I began taking my blue pill, HIV haunted me as a self-fulfilling prophecy. I’m a 31-year-old gay man. Like many gay men, it seemed to be more an eventuality than a possibility. I expected to get HIV at some point. It’s what happens to gay men, right?
HIV isn’t an eventuality. Thanks to modern science we have the tools to end HIV, and my blue pill is just one of them. In 2012 the FDA approved the medication Truvada for use as pre-exposure prophylaxis, or PrEP, for HIV. One daily blue pill can prevent someone who is HIV-negative from contracting the virus. Think birth control for HIV.
When taken daily, PrEP is over 99 percent effective. Taking this medication has liberated me from living in constant fear of getting HIV and empowered me to proactively take charge of my health.
There’s also post-exposure prophylaxis, or PEP — similar to the “morning after” pill. The treatment can be started within 72 hours after a used needle stick or sexual encounter to prevent contracting the virus.
Finally, there is HIV treatment as prevention, or TasP. Someone HIV-positive who is on effective treatment and has had an undetectable viral load for at least six months can’t transmit HIV. Undetectable = Untransmittable. Whoa. That’s big news too.
If you’re not LGBTQ, you probably haven’t heard much about any of these remarkable breakthroughs. Even the LGBTQ community is reluctant to talk about them. So why aren’t we shouting from the rooftops that we can finally end HIV?
One major reason is the stigma we continue to attach to HIV. The communities hit hardest by HIV — communities of color and LGBTQ — still find HIV difficult to discuss. It took years for our government to respond to the HIV/AIDS epidemic — years measured in countless lost lives. And once medication became so effective that people weren’t dying within months or years of their HIV diagnosis, we stopped talking about it in public. Let’s be honest — we don't want to talk about a subject so “dirty” and “taboo” as the virus. Out of sight, out of mind.
Over the last year I’ve been told by many in the public health community that Kansas City isn’t ready for this conversation. However, if we can’t talk about HIV in public, let alone talk about ending a disease which disproportionately impacts people of color and LGBTQ individuals in our own community just because it’s uncomfortable, then we are choosing to sustain a disease that has long overstayed its welcome. As long as we stigmatize HIV, it will never end.
So, Kansas City…we need to talk. Is now a good time?