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I thought taking Truvada (or PrEP, meaning pre-exposure prophylaxis) to prevent HIV infection would bring out the demon inside of me, and very quickly I’d be splayed out in some dank sex dungeon ready to take all cummers. I’d pop my “gay birth control” and let my anus blossom into the disease vector it wants to be.

Alas, this did not happen. My Truvada odyssey ended with me crying in the lap of a beautiful young man, telling him I felt like my guts were boiling, and that I needed his calm hands to open a pack of chewable Pepto Bismol. I made it just three weeks taking Truvada, the purported prescription savior of the gay community, before I broke down from the feeling of being poisoned. First came the nausea—so severe I would gag and puke while brushing my teeth. Next came extreme abdominal pain. My innards felt like they were going to rot and fall out of me. And even though I had no appetite for food, I could still fart prodigiously and fill the toilet with diarrhea! Not to mention vivid nightmares about death and dismemberment, and a day I felt so paranoid a friend had to assure me nobody was tailing my car. I didn’t even make it through an entire bottle before I quit. All in all, taking powerful anti-retrovirals (the same medicines used to treat people who are HIV+) was a nauseating, disturbing experience.

I asked my doctor for Truvada because a threesome I set up came precariously close to infecting me and my best-friend-with-benefits, Randy, with HIV. Charlie, a cute twink boy we liked to hook up with, was unknowingly infected and shedding the virus while the three of us sucked, fucked, and did everything every which way possible. Randy always insists we use condoms, which I am incredibly thankful for. Both of us literally came within a millimeter of latex from contracting HIV. As Randy likes to say, “That probably wasn’t the first, and certainly won’t be the last time you unwittingly had sex with an HIV+ partner.”

He’s right, which terrifies me. I live in Atlanta, a city facing a crisis of new HIV infection, and several of my hook ups have contracted HIV in their early twenties. Fear of the virus is so ingrained in me that I have never trusted or loved another man enough to have unprotected anal sex. On the one hand, my fellow gays rightfully call me a homophobic, un-liberated prude brainwashed by the “gay sex is bad” public health message. On the other hand, I’ve fucked a lot of guys and never gotten an STI—simply because I wrap it up. I hear my gay community calling me to move past HIV status and live a life open to everyone, but I’m not sure I can do that. My desire to practice safe, pro-condom sex has become stigmatized. Gay guys are increasingly interested in having bareback sexual encounters like it’s the late 70s again, and they look at me like I’m some hopelessly backwards, sexually conservative asshole because I don’t want to use my PrEP prescription as a license to swap cum with dudes I’ve known for two drinks. “Serosorting” ourselves into having sex with guys of a similar status is now taboo. I feel like unless I’m willing, as an HIV-negative man, to have a an uninhibited sexual relationship with a HIV-positive man, then I’m a completely hateful, close-minded, status-ist piece of shit.

Truthfully, there are a lot of really smoking hot HIV+ guys who’s cock I’d love to chug. Sometimes I’ll top an HIV+ guy, but I’m too scared to do anything else that exposes me to their bodily fluids. No cock sucking. No ass eating. I fuck them, behind latex, and that’s it. Even though I know an HIV+ man on meds is safer than someone who mistakenly thinks they are HIV-, I just can’t bring myself to be open sexually to poz guys. I wanted Truvada to change all this. I want to get on my knees and orally service a hot, hung HIV+ man until he was so horny he had to pound my ass until he blew his load in a condom. And because I’d taken my gay birth control, I wouldn’t be worried about anything more than getting crabs from his grungy, unwashed Ikea bedsheets. Thankfully my dream of fearlessly deepthroating an HIV+ guy never came to fruition. The Truvada would have made me puke all over his dick which would have been a total boner kill.

When I went to pick up my first bottle of Truvada, I fantasized about being able to move past HIV in my mind—finally, my fear of becoming infected would be washed away by this new medicine. When I said I was new to the drug the pharmacist asked how long I expected to take this medicine, and I replied “As long as I think it’s necessary in my life.” A look of sadness and embarrassment poured over her face. “You do know you are going to have to take HIV medicine for the rest of your life?” I looked at her quizzically, then realized the miscommunication. She though I was HIV+. I explained to her I’m taking this as PrEP, and that I’m HIV-. “Whew,” she said. “I thought you were going to have to take this forever and didn’t know it.”

The dark specter of HIV has hovered over my soul for a decade now, and I really want it to go away. Even before I knew what gayness meant in my life, I knew that HIV was some terrible plague I did not want to step into. Every time I get tested for HIV I feel ashamed of all the hot, meaningless sex I have. I convince myself “this is it” whenever they call me back to hear my results. Some innocent-looking college boy surely infected me while I gave him a blowjob in the library bathroom. Even if I haven’t taken a load of cum up my ass, or shared a needle, or done some irrevocably dangerous thing, I always think I’m in for the worst. I hoped that by taking Truvada, I could rid myself of this existential nausea.

Turns out, this medicine just replaced existential nausea with physical nausea, which was too much for me to handle. I’m incredibly privileged to experiment with healthcare options like Truvada, and to be able to choose not to take it. My job provides great healthcare which made this an affordable experiment. Otherwise I’d likely have to jump through many hoops just to be able to afford this $1000+ a month option. Perhaps the biggest privilege I have is choosing not to take Truvada. If I were infected with HIV, I would have no option but to take this and other antiretrovirals every day until I die. Frequent nausea and vomiting would be part of my life, and I would have to shut up and deal with. I wanted to be part of the solution. I wanted to be part of the PrEP revolution. Sadly, I don’t have the stomach for it.