#IfYouAreBehind — A Song of Love / High Cost of PrEP / Open Relationships

Slant Magazine

Art: Praz-Delavallade, a Parisian gallery that has opened its first space in the Los Angeles area, just completed an exhibition called Over the Rainbow. Its main dedication was to the socio-political trajectory of the LGBTQ movement through painting, photography, sculpture, and video. The gallery brought together an “intergenerational group of artists drawn from a global spectrum of interests and backgrounds, each looking at seminal moments in the gay liberation movement”.

Of note, one of the highlights was the work of Jean Genet, who was a French novelist, playwright, poet, essayist, filmmaker, and political activist. A film titled Un chant d’amour (A Song of Love), directed in 1950 and his only attempt at cinema, was described in The Queer Encyclopedia of Film & Television as “one of the earliest and most remarkable attempts to portray homosexual passion on screen”. Because of its explicit (though artistically presented) homosexual content, the 26-minute movie was long banned.

What is truly fascinating is that, although it was released more than 60 years ago, its story is still highly relevant — two individuals with an incalculable attraction between them, who are unable to physically touch.

In 1966, Saul Landau, an American journalist, filmmaker and commentator, attempted to exhibit the film in Berkeley, California and was clearly met with opposition. Yet this push-back prompted him to file the case of Landau v. Fording (1966). The courts rejected his suit on claims of it “promoting homosexuality”, yet he and his constituents didn’t stop there. This claim went all the way the Supreme Court where the decision was confirmed once more, in a 5–4 per curiam decision in which the justices simply stated that Un chant d’amour was “obscene” and offered no further explanation.

Despite this, Un chant d’amour and all of Jean Genet’s work have been cited as an influence for many gay artists including Derek Jarman, Andy Warhol, and Paul Morrissey.

The media of art continues to be a huge support of the work all of us do on a daily basis. The key to betterment is through not only the actual piece of art created, but also the stories that lie within. Every artist depicting “seminal moments” in any liberation movement, creates a road map to the history that never should be repeated. But it is up to the current persons, through the artist’s work, to unlock these historical events and continue to persevere in the fight for equality.

👏 to Praz-Delavallade and their dedication to the cause because without their gallery, these important figures — the likes of Jean Genet and Saul Landau — would vanish in history, taking their stories along with them.

Alexander Kroll

Science: This week Bloomberg broke a story “How a Blue Pill Is Stopping the Spread of HIV” and the most staggering disclosure doesn’t come from the term “stopping the spread” but from the overall cost (or shall we say profit) of this little fucking blue pill. Before the shock, let’s first set the stage with some education.

The little blue pill is known as Truvada or more commonly PrEP. If taken daily, PrEP reduces the risk of HIV from sex by more than 90 percent. Gilead counted only 136,000 people taking Truvada as PrEP at the end of the second quarter (a shockingly low number to me), compared with 60,000 to 70,000 a year earlier. That’s still a fraction of the 1.2 million American adults at significant risk. Clearly, whoever uses it has shown efficacy, with reducing HIV diagnoses overall. Both the U.K. and San Francisco have reported HIV disease has plunged by 42 and 50 percent, respectively. While an amazing improvement, there is clearly so much room for betterment with both proper identifying via risk assessment and improved education of practitioners on its prescribing power.

But, as stated prior and coming from Bloomberg news, 💵 and cents will always be the biggest hindrance. So… drumroll please!

Truvada (PrEP) costs about $17,258 per person a year in the U.S. Compare this to the annual cost of about $67 per person for a generic version in India.

What the fuck is this? Think about it: the cost of one person in the United States can treat 257 people in India. This makes it very clear that the most effective way to increase usage is to decrease cost. Care for another staggering statistic? This 13-year-old medication’s sales have reached $3.57 billion in 2016. We knew the gays were big spenders, but this gives it a whole new meaning.

Who’s to blame for these elevated prices? Is it the drug manufacturer or the insurance companies? Is it the American dream of capitalism? What and who defines these values and at what cost to the people? Unfortunately, there is no easy answer. Everyone plays a part in this corrupt system. And to think: how many more individuals could benefit from the generic version, which means quicker success with complete eradication of the HIV disease? But don’t hold your breath — this won’t happen until everyone gets their “fair” cut.

Sex: Last week, Davey Wavey, a digital storyteller of all-things-gay, released “How To Have An Open Relationship” both in the Huffington Post and on his YouTube channel. The content is considered an open relationship starter guide, sharing both his own and his sex therapist’s insights and thoughts. Kudos to him for continuing to tackle these complex scenarios and being able to reach million of viewers. On the topic of opening, he is quoted as saying, “all of us deserve to create the relationships that make us happy, and different things work for different people at different times…There’s no shame in that…”

He breaks down his four key tips (to which I will later add a fifth) to a successful open relationship:

  1. Start in a good place — not when one is angry or the relationship is not on solid ground
  2. Express why you want it — be sincere in the realism of your own Freudian id, ego, and super-ego
  3. Set ground rules — making sure these are mutually discussed, honored, and re-evaluated
  4. Say that “it’s not forever” — or it could be — but all parties are involved in the decision making

Yet, there is one rule that was not touched upon at all, which I believe is essential: assessing one’s sexual and medical risk prior to open sexual engagement. I am a big proponent of seeing a physician who is either gay or understands the sensitivities of our community because your physician should be involved in the decision making process of opening up your relationship. This helps to analyze one’s sexual practices, desires, and realistic expectations, all while maximizing safe encounters. And it’s not only one’s personal risks, but it’s the risk multiplied by all the different partners, primary and beyond.

Defining your openness calls into question what specific sexual acts will be performed. Understanding one’s true practices allows for the best insight into the minimization of risk. There should not be any judgements or biases on what one chooses to practice.

Having access to healthcare that provides the support for one’s desires — like Bespoke Surgical — is vital in not just open relationships, but all relationships.

While these are just a few examples of the medical ramifications of opening one’s relationship, they should be questioned by all:

  • Are you engaging in oral, anal, fisting, rimming, orgies, or sexual drug use (there are different risks for each of these!)?
  • Do you use protection?
  • Are you on Truvada (PrEP)? If not, do you know about it and or do you have access to it? Also, if not taking PrEP, do you have access to post-exposure prophylaxis (PEP) if it becomes a risky encounter?
  • How do you prepare if you’re engaging anally (enemas — chemical or water-based, shower hoses, or just external cleaning)?
  • Are you and your partners practicing an STD screening protocol, at least every three months (this might be more frequently depending on your sexual habits), which allows for safe sexual practices?
  • What is your management plan when one tests positive for an STD? It is, for the most part, inevitable and should not be thought of as shameful. There should be an immediate plan in place to make sure everyone is notified and treated according to standard protocols.
  • What’s your oral and anal HPV status? Vaccination can be obtained, even over the age of 26, which lowers one’s chances of getting high risk strains.

According to his HuffPo bio, Davey Wavey has reached more than 400 million people around the world. This means it is imperative that his voice, among all other millennial YouTubers, commits to providing credible content, merit across the entire spectrum, and true accountability. With the world watching, specifically the inexperienced and very curious gay youth, I do hope more professionals, like myself, offer their expertise in this educational mission of our culture.