SAVAGE LOVE

BY DAN SAVAGE

DEAR DAN: I had back surgery (my third) in 2022, and I’ve been on an antiinflammatory drug ever since to help deal with the pain. I’m a gay man, and I’m ready to start having sex again. But when I looked into starting up on PrEP, I learned that there is a potential for a drug interaction impacting the kidneys if you combine PrEP with the anti-inflammatory drugs I’ve been prescribed. So, they will not permit me to take these two drugs together. I know that the anti-inflammatory drug really does help ease the pain, so I’ve decided to remain on that medication. My question is how to deal with the issue of PrEP on online dating sites. Do I leave that question blank and let the other person guess or should I add an explanation? I was thinking of something like, “Can’t take PrEP due to potential negative drug interaction with medication I’m taking for back issues. Would if I could and I hope you are!” Anxious to hear your thoughts.

— Pain In The Back

DEAR PITB: PrEP is a daily medication that HIV-negative gay and bi men can take — it’s a daily medication the Centers for Disease Control urges all sexually-active gay and bi men to take — that significantly reduces the risk of HIV infection. PrEP doesn’t protect against other sexually transmitted infections (syphilis, gonorrhea, chlamydia, etc.), and gay and bi men should consider using condoms with casual sex partners — particularly now. Rates of syphilis are way up among gay and bi men, and there’s a nationwide shortage of the drug used to treat syphilis. So, guys… it’s time to stop

Send considering using condoms and actually start using them, at least until the drug shortage is resolved.

While PrEP isn’t a vaccine, the principles of herd immunity — which are usually discussed in relationship to vaccination campaigns — more than apply. When everyone who can get vaccinated does, people who can’t get vaccinated for legitimate reasons (life-threatening allergies, currently undergoing chemotherapy, etc.) are protected from the disease. So, even though you can’t take PrEP, PITB, it’s a good idea for you to seek out partners who are on PrEP, and putting a line that explaining that you’re not on PrEP and why — and indicating that you would be on PrEP if you could be on PrEP — helps to normalize the use of PrEP and that makes everyone safer, yourself included. (Look at me, normalizing PrEP by using it six times in one sentence!)