He’s Straight. So Why Is He Taking PrEP?

A few days ago, we were talking with another couple when they mentioned that a man we know in the lifestyle takes PrEP.

I had no idea what PrEP was.

They explained that it’s medication taken to greatly reduce the risk of getting HIV.

My first question was probably predictable:

Why would he be taking that? He’s heterosexual.

As soon as I said it, though, I realized I really didn’t know enough about PrEP, or apparently about HIV prevention today, to know whether my question even made sense.

So I started asking questions.

Apparently, I Had Put PrEP in a Box

Like a lot of people, I associated HIV prevention medication primarily with gay and bisexual men. In my case, I didn’t even know the name PrEP. But once someone explained what it was, that was immediately where my mind went.

And yet the man we were talking about is married to a woman. As far as I know, he is heterosexual.

Then I thought about what else I know about this couple.

They have a lot of sexual partners.

They play without condoms.

And suddenly my question became:

Why wouldn’t someone in that situation at least consider PrEP?

HIV risk is about exposure, not whether you identify as gay, straight or bisexual.

One Partner Isn't Really One Partner

This is something we all understand intellectually in the swinger lifestyle, but I’m not sure we always think about what it really means.

You aren't exposed only to the person you're having sex with.

You're connected, sexually, to the people they've had sex with. And those people have partners. Some of those partners have other partners.

That doesn't mean everyone should panic and start drawing sexual family trees on cocktail napkins.

But if you and your partner routinely have condomless sex with multiple people, your sexual network can become fairly large without your ever actually knowing how large it is.

And a negative STI test is a snapshot in time. It can't tell you what happened after the test, and some infections may not be detectable immediately after exposure.

So What Exactly Is PrEP?

PrEP stands for pre-exposure prophylaxis.

It is medication for people who do not have HIV that can dramatically reduce their chance of acquiring HIV. There are daily oral medications as well as long-acting injectable options.

When taken as prescribed, PrEP reduces the risk of getting HIV from sex by about 99%.

What surprised me was that PrEP isn't just for gay or bisexual men. Heterosexual men and women can take it too.

Once I understood that, a heterosexual swinger taking PrEP stopped seeming unusual.

In fact, it started sounding pretty logical.

But There Is a Very Important Catch

PrEP prevents HIV.

It does not prevent gonorrhea, chlamydia, syphilis, herpes, HPV or the other sexually transmitted infections people in the lifestyle are much more accustomed to discussing.

So taking PrEP isn't a magical force field around someone's sex life, and it isn't a substitute for deciding what level of risk you're comfortable with.

It's one tool aimed at one infection.

When Did We Stop Talking About HIV?

This may be the part that interested me most.

There was a time when HIV and AIDS were impossible to ignore. They were in the news, in movies, in schools and in conversations about sex.

Today?

When swingers talk about sexual health, I hear plenty about testing. I hear about herpes. I hear about condoms. I hear people discussing whether someone recently had an STI.

I can't remember the last time I heard heterosexual swingers sitting around talking about HIV prevention.

Until someone mentioned PrEP.

And I didn't even know what it was.

Maybe that's because HIV prevention has become so much more effective. Maybe it's because HIV has become associated in many people's minds with certain populations rather than with certain behaviors. Or maybe those of us who remember the AIDS crisis have watched HIV move so far out of the daily conversation that we stopped updating what we knew about it.

Whatever the reason, I learned something from one very casual conversation.

The interesting question wasn't really:

Why is a heterosexual man taking PrEP?

After learning a little more about it, my question became:

Why did I think a heterosexual man wouldn't?

And if you're sexually active with multiple partners, particularly without condoms, it might be a question worth asking yourself too.

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*This article is about sexual-health awareness and isn't medical advice. Decisions about PrEP, HIV testing and STI prevention should be discussed with a healthcare professional.