Casper had moved to New York nearly two years earlier after graduating from an elite East Coast liberal arts school, and he had been doing sex work casually through Craigslist and Grindr to supplement his income ever since. In the months prior, Casper had seen posts on Facebook from some of his gay friends about a pill that, when taken every day, could protect a healthy person from contracting HIV.
Like many young gay men growing up in the mid 90s, Casper had internalized a deep fear of HIV and the injunction to always practice safe sex to protect against it.
A pill that could virtually eliminate the threat of infection sounded like a miracle, especially since his work put him at a higher risk of contracting the virus.
Statistics about infection rates among sex workers are hard to come by because the criminalization and stigmatization of the profession have made population-based studies in the United States nearly impossible. He felt safe saying no, but the demand came up again and again. He was intrigued about a pill that could further allay his anxiety and also give him the flexibility to make more money if he needed it.
Straight people bareback all the time, he thought, and he felt he had the same right with partners and clients if he chose. So after he peed in a cup and had his blood drawn, he asked the clinician what he had to do to get a prescription for the HIV prophylaxis. The clinician gave him a confused look and told him that no such medication existed. But the pill was very real. It had been more than a year since the Food and Drug Administration approved the use of the drug Truvada to protect individuals at a high risk of HIV infection, a regimen known as PrEP, for pre-exposure prophylaxis.
