From sodomites to PrEP sluts
Conversations about PrEP and especially its users are often desachalised and full of prejudices. Our author gets to the bottom of this phenomenon.
When a new method becomes known that gay and bisexual men can use to effectively protect themselves from HIV infection, it should be expected that those affected will generally look at it favourably and weigh up the opportunities and risks of this new option objectively. This is happening, but something else is happening at the same time. Discussions about pre-exposure prophylaxis (PrEP), which is now also becoming increasingly established in Germany, are regularly clouded by disturbing disregard for facts, obdurate denial of facts, increased troll density and generally above-average irradiation. Typical comments look like this, for example:
"Why should healthy people take dangerous drugs? If the bareback scene dicks are too lazy or too stupid to use a condom, then they deserve their infection!"
"Am I supposed to use my health insurance to pay for irresponsible darkroom sluts' party fun? If they absolutely have to fuck their way through all the beds, then they should at least pay for it themselves!"
At least online, I've never seen a discussion in which several people don't come around the corner with these and similar "arguments" to condemn PrEP and those who use it in no uncertain terms. The lines of these discussions are so strikingly similar each time that you could create a PrEP bullshit bingo from just one. Medical and statistical facts are simply denied or reinvented; the small residual risk is overdramatised. After just a short time, insulting words are hurled and angry personal attacks are launched.
Of course, PrEP should not be met with uncritical jubilation, but rather a balanced debate in which costs and side effects, lobby interests, the medicalisation of our sexuality and much more should also be discussed. However, it cannot be overlooked that an astonishing number of people in these discussions are primarily concerned with letting their own resentments take centre stage, often noticeably - and suspiciously - with relish, despite their breathtaking resistance to facts. This needs to be explained. Why is this topic often so conspicuously unobjective and aggressive?
Our society (and even more so the gay subculture) delights in the myth that we have largely overcome something as medieval as "sexual hostility". Instead, we like to lament the omnipresent "over-sexualisation" or the "end of all sexual taboos". I would like to attempt an explanation that refutes this myth and expand a little on it.
Devilish seduction
Early modern Europe is probably rightly categorised as not overly hedonistic. Power strategies closely intertwined with religion had solidified a morality that largely demonised sexuality and only tolerated it as a necessary evil where it was bound to the purpose of procreation, strictly monogamous and carried out relatively lust-free.
In this climate, homosexuality presented itself as the perfect wall on which to paint the literal devil: The confines of a monogamous marriage union no longer applied, and biology regularly stood in the way of procreation; all that remained was pure, self-justifying lust. An abomination. The purposelessness and licentiousness of this type of sexuality made it the enemy of a religious morality that preached renunciation of pleasure, discipline and restraint of all physical desires. This morality was based on rules that did not need to be rationalised or explained to the individual. It was rooted in an unquestionable religious ideology and was enforced by authoritarian force. Anyone who broke the rules was guilty of sin, anyone who questioned them was guilty of heresy.
In the logic of the time, allowing homosexuality would have seemed highly dangerous because it would have symbolically called into question the foundation of society: blind cadaver obedience to predetermined (not only) religious rules. So-called sodomy, which in addition to homosexuality also included every other form of non-religiously certified sexuality at the time, was not only sinful, but also dangerous to society. In extreme cases, such diabolical behaviour was punished with physical destruction.
Diabolical legacy
When the homosexual emerged onto the historical stage as a medically pathologised being, society, which was more enlightened in some respects, had still deeply internalised traditional sexual morality, and so the homosexual quite seamlessly took over the legacy of the sodomite. The licentiousness that the sodomite had been accused of was now attributed to the typical homosexual as a pathological sexual lust that could be directed indiscriminately at any halfway male object (or even anything else).
The non-confinement of sexuality was given the new label promiscuity. It was no longer just outrageous that sexuality took place outside of the marital context, but also - or perhaps even more so - that it was not content with a single partner.
If the label of sin was now partially transformed into that of disease, the idea remained that this evil would spread and destroy the whole of society if it was not simultaneously outlawed in society as a whole and destroyed in each individual. The fear of the devil's seductions could be translated quite effortlessly into a secular vocabulary of contagion: the keyword of "seduction" even remained, and with it the idea that we were dealing with a demonic phenomenon that could seize innocent people and morally corrupt them.The fear of the society-destroying power of non-heteronormative sexuality has survived to this day, and not only in explicitly nationalist circles.
A new development was that at some point more and more homosexual men
- who gradually became gay - looked for same-sex relationship alternatives because they increasingly recognised their homosexual desire as an obstacle to entering into a heterosexual marriage. The fact that lasting gay relationships remained barely viable for a long time thanks to massive social sabotage was in turn blamed on the gays themselves as a hedonistic inability to commit.
The agreement remained unchanged that all behaviour that deviated from the heterosexual monogamy norm could of course be devalued and punished without having to present a single rational argument. Punishment was justified solely by the old, deep unease about a sexual desire that existed only for its own sake and which undermined and questioned central norms with a disturbing tenacity. Traditional sexual morality continued to anchor - structurally and individually - an abysmal fear of a supposedly disinhibited and therefore dangerous sexuality. This fear fed a massive emotional defence that could only find reassurance in punishing or destroying those who jumped over the fence of permitted, disciplined sexuality. Homosexuality remained - and remains to this day - one of the most important projection surfaces for anti-sexual fears.
The scourge of God
With the emergence of the HI virus in Europe, the coordinates of this projection shifted. To this day, the phrase "AIDS as the scourge of God" rings in our ears from the debates of the initial phase, drowning out everything else. This phrase revealed with shocking clarity a lust for punishment that still yearned for the physical annihilation of sexual deviants. The fact that the extermination of perverts was delegated to a deity could rarely conceal the regret of not being allowed to take on this righteous task themselves. HIV and Aids (or rather the fantasies about HIV-positive people), like a new centre of gravity, quickly took over all anti-sexual fear projections.
For reasons of prevention strategy, it made sense at this time to bring concrete sexual practices and subcultural infrastructures into the media spotlight. The old topos of disinhibited sexuality could now be attached to the unveiled panopticon of sexual excesses that heteronormative society had not yet seen in such a detailed form. Anal sex, blow jobs, darkrooms, fisting, fetishes, sex parties and BDSM practices made the public shudder in pleasant horror - and the old accusation of the licentiousness of gay sexuality was given new, highly impressive illustrations. It was presumably this experience that led to the myth that all sexual taboos had been abolished; a myth that, of course, does not change the fact that the old devaluations were often only reaffirmed in the public discussion of various sexual varieties.
HIV was, of course, the perfect vehicle to propel the never-ending fear that gays would sooner or later destroy society as a whole into new dimensions, as if with a fresh turbo engine. In the undoubtedly initially uncertain epidemiological situation, apocalyptic visions sprouted up in which gay "virus slingers" and their diabolical helpers, the bisexual men, wiped out half nations. Alarmist articles in Der Spiegel, for example, made serious use of the imagery of the Book of Revelation. Nothing seemed too exaggerated to to visualise hellwhich the uninhibited, immoral sexuality of gays would turn our beautiful country into in the blink of an eye. Many media took on the inglorious function of turning the population's old sexual fears into profit and at the same time irresponsibly amplifying them to the point of grotesqueness. Not only people affected by HIV, but all of us are still paying a high price for this today.
The moral pretence that sexuality is only ethically acceptable in the context of monogamous relationships was also easily woven into the HIV debates. Despite all the medical facts, the myth of the "safe monogamous relationship" is still told today, in contrast to the "dangerous promiscuous sex". Safer or unsafe sex? Not so important. Instead, the more immoral sex must always be the riskier sex, so that the old compass doesn't get thrown into a spin by disturbing facts. It cannot be overlooked that a moralising logic of desire is being superimposed on reality here, according to which immorally uninhibited sexuality must always and everywhere be punished and virtuously disciplined sexuality rewarded. Unfortunately, the gay subculture sometimes eagerly knits these narratives together.
The extent to which discussions about HIV are characterised by moral issues rather than rational considerations is shown by how often the word "guilt" is bandied about in these discussions. Those who are "guilty" of their own infection are those who are also guilty of already immoral behaviour: They have indulged in "wrong" (promiscuous, excessive, "perverse"...) sexuality or, just as bad, consumed drugs. "Innocent" HIV-positive people are, for example, people who were infected through blood or by their mother at birth. Many openly HIV-positive people are repeatedly confronted with the question of how they could have become infected, and this question is often more or less deliberately aimed at categorising the interviewees as "guilty" or "innocent" HIV-positive. The great need for this categorisation would be difficult to explain without the background of restrictive sexual morality, which is essentially still based on the old notions of sin.
Even today, the counselling centres of AIDS service organisations regularly receive clients who have not actually taken any real risk of infection, but who nevertheless fantasise about it with might and main simply because they have done something sexual that they classify as wrong or immoral. Their moral conditioning whispers to them: Wrong sexuality is always punished, and the punishment is called HIV. The scourge of God still whips through their heads.
Media reports in which a knowingly HIV-positive person ends up in court because he allegedly deliberately infected an "innocent person" are always a source of particular fascination. In the discussions of these cases, a merely negligent acceptance of an intentionally induced infection is regularly fantasised, failure to discuss the respective serostatus on both sides becomes a one-sided "lie", HIV becomes a "death sentence" and the infection consequently becomes "murder". And the HIV-positive person is always solely responsible for the fact that the other person did not insist on safer sex. This all follows the pattern of linking HIV with every conceivable evil, even against the factual reality.
What is interesting here is the fervour with which the HIV-positive person is painted as black as possible in such reports and the fact that the other person involved, who in any other situation would probably have been accused of recklessly foregoing protection, suddenly mutates into an innocent victim as soon as someone who is knowingly HIV-positive is involved. His infection marks his moral depravity from the outset and makes him a suitable scapegoat on whom all further blame can also be laid. Of course, one of the reasons why these reports are so popular is that they finally allow us to talk openly about the just punishment of immoral and consequently harmful sexuality. This immoral and dangerous sexuality is thus banished - at least in the imagination - from society and from one's own morally ideal and safe world, and that seems tremendously relieving.
HIV has, at least in Central Europe, become a largely treatable chronic disease. Against this background, it needs to be explained why so many people, including not least gay men, cling so vehemently to the horror images of the "old HIV". If we assume, as described above, that the narrative of HIV as a just punishment for transgressing sexual norms satisfied a conscious or unconscious moral need, then it is only logical that some people would miss something if this welcome narrative suddenly lost its power again. Instead of welcoming the new situation with relief, it is perceived as unsettling. If we assume that an internalised moral self-deprecation is still widespread among gay men (and there is evidence for this Many things), then it is plausible that this can also lead to irrational adherence to such punishment narratives among gays.
At a time when gay emancipation was showing the first tentative successes in questioning and dissolving anti-sexual structures, the emergence of HIV and AIDS set these efforts back by at least decades. The conceptual link between uninhibited, immoral sexuality, social apocalypse and just punishment, including annihilation, celebrated a triumphant return that no one had expected with such force.
The precision with which the old anti-sexual prejudices and clichés were revived with HIV as a new focus in a dramatised and newly illustrated form is remarkable: the unbridled sexuality, the hedonistic refusal of commitment and responsibility, which manifested itself above all in promiscuity, the general immorality and the fantasised danger to society that resulted from all of this. The old patterns of sexual panic remained exactly the same. They were directed at HIV-positive people as if with a burning mirror.
Renunciation of pleasure
As the AIDS hysteria gradually subsided, two new ways of escaping total ostracism emerged for those gays who had not yet fallen victim to the eternal moral damnation of HIV: Condom use and monogamy. It is no coincidence that both options have to do with renouncing pleasure.
Some theorists such as Michael Bochow and Stefan Nagel have analysed the symbolic function of condom use and have come to similar conclusions. According to them, the astonishingly successful condomisation of gay sexuality is not only due to the medical preventive effect, but also to a symbolic charge of the condom, which came about as an unplanned side effect: Anyone who uses a condom proves that they are capable of remaining rational and responsible even when sexually aroused. At the very moment when the opportunity arises to completely surrender to pleasure, to let go of reason and everyday rules of behaviour and to experience the dissolution of boundaries, the condom brings into play such repulsive thoughts as illness, death and medical facts. In addition to the haptic reduction in sensation that the rubber skin brings with it, this is a considerable loss of pleasure.
The concept of safer sex requires you to consistently train yourself to think about potentially deadly viruses in every horny situation. This borders on self-flagellation - and that is precisely the joke on the symbolic level: anyone who is prepared to renounce pleasure in this way refutes the accusation of licentiousness and indiscipline. Anyone who combines pleasure with responsibility cannot be completely immoral. Against the backdrop of a sexual morality that still idealises the renunciation of pleasure, gay sexuality with a condom (or without certain practices) becomes easier to tolerate precisely because it is no longer as much fun. By (apparently) voluntarily disciplining himself, the gay condom user appeases society's fear of his supposedly completely disinhibited sexuality.
This symbolic level meshes perfectly with the medical level: the symbolic (and factual) disciplining goes hand in hand with an actually reduced risk of infection. We are dealing here with the exact mirror image of the counter-narrative to the "scourge of God": Sexual self-taming leads to the absence of punishment by HIV. The virtuous renunciation of pleasure is thus doubly rewarded: through medical protection and reduced social ostracism. In an era of end-time expectations, in which gays expected to be interned in concentration camps and heterosexuals expected to skip a fatal epidemic, the condom became a saving indulgence - but not for everyone.
Monogamy
I will only briefly discuss monogamy as a second option for reducing the number of males. In my Articles on marriage Peter Rehberg with the Statement that lesbians and gays "intuitively know that their success in the mainstream depends on their desexualised representation." Although it should be relatively clear that gay monogamous couples usually still have sex in some way, the decisive factor in this context is that the opportunity is now opening up to present this sexuality as just as contained and disciplined as the marital sex of heterosexuals.
The fact that this presentation also goes hand in hand with the hope of greater acceptance is demonstrated by the many "good homos" who would like nothing more than for the more immoral, wild sexuality of their peers to become as invisible as possible and disappear, so that they are no longer associated with such excesses. And perhaps it is no exaggeration to assume that the success of marriage for all is partly based on the more or less conscious wishful vision that really "everyone" should please nest their sexuality in a sexually exclusive, lifelong, state-certified form of couple relationship and swear off other misdemeanours. The fact that even gays harboured this wish seemed to be such a relieving confirmation of this vision that people were even willing to overlook the less serious violation of the rules of same-sex marriage.
Good and bad gays
Condom symbolism and the glorification of monogamy have their downside: gay men who, despite these tempting options, cling to a sexuality fantasised as "wild and dangerous", continue to be stigmatised, perhaps even increasingly so - both by parts of society in general and within the so-called community itself. An increasingly clear distinction is being established between the good and the bad gays, and the lines of demarcation run mainly along the line between good sexuality (monogamous, non-"kinky", with a condom) and bad sexuality (promiscuous, "kinky", without a condom). The old rules, according to which sexuality must be disciplined, standardised, responsible and safe (whatever exactly one fantasises as a danger) in order to be acceptable, divide our so-called community into two halves.
The sacred condom
Against the backdrop of this development in sexual morality, in 2008 the ExplanationThe fact that a person undergoing successful HIV treatment is generally unable to pass on the HI virus even if they do not use a condom is more or less a scandal. What is particularly interesting is that the almost overcareful scientific backing for this message to alarmed critics hardly impressed.
In 2015, for example, when a spokesperson for the school education project SchLAu NRW announced on his private facebook page that, as a gay man undergoing HIV treatment, he did not use condoms during sex, he was criticised by various political pages and Media attacked in such an aggressive manner that in the end only the Resignation from his role so as not to harm the project. He was not only accused of counteracting his educational work with this "irresponsible" statement, but also of having "frequently changing partners". All the facts about protection through therapy (which must of course be just as much a part of sex education as protection through condoms) were ignored by the critics with breathtaking ignorance. Instead, they painted an alarmist picture of a sexually licentious person who, by publicising her irresponsible sex life, was corrupting innocent young people with trivialising messages. Immoral sexuality, irresponsibility, promiscuity, seduction, danger: we are encountering a familiar demon again.
In this context, Stefan Nagel speaks of the "sacred condom", meaning that in the long period in which condom use was so vehemently and successfully propagated as an effective prevention option, the symbolic function of the condom (as proof of the only responsible and therefore morally acceptable behaviour) has become detached from the medical-factual level and has largely taken on a life of its own: Since then, only the condom user can be considered to have moral integrity, even if new facts theoretically relativise this. Anyone who does not comply with this norm is immoral. But anyone who even publicly questions the norm is demonised as a heretic and cast out. The punishment can be metaphorical ("deserves HIV") or very concrete (insult, public condemnation, exclusion, etc.).
Perhaps it is debatable whether condom use still mainly triggers the fantasy of "disinhibited" sexuality that I emphasised or whether the irrational condom norm can now also be explained without this root. In any case, the traditional idea that "wrong", "dangerous" sexuality should be ostracised and punished has become attached to the issue of condom use to a considerable extent.
New old moral panic
It is only with these thoughts in mind that the irrationality and aggression with which many people react to PrEP can be explained. They are an echo of the traditional fear of the alleged destructive power of uninhibited, undisciplined, irresponsible sexuality and the desire to punish associated with it. The moral perspective is still so powerful that it simply pushes aside the medical-factual reality.
PrEP also requires a certain amount of discipline in order to be effective. In contrast to condom use, however, this discipline is not required at the decisive moment of pleasure, but is separated from it in time; you don't just take the pill shortly beforehand. Spontaneous pleasure becomes possible again without being directly linked to fear. What for many people is an enormous gain in pleasure and for some has even made pleasurable sexuality possible again in the first place, comes under suspicion on a symbolic level precisely because of this: pleasure without negative thoughts can't be entirely kosher after all.
It is interesting that in many discussions about HIV, the actually positive keyword "carelessness" has an extremely negative connotation. Even the first condom campaigns were accused of promoting a "dangerous carelessness" that could only lead to a drastic explosion in the number of infections (the better alternatives were - who is still surprised? - abstinence or monogamy). The same applied to protection through therapy and now applies to PrEP. Since the beginning of HIV prevention, almost every single year has seen an increase in the number of infections. "new" carefree attitude discovered, even if the fairly stable infection figures never actually indicate this. Strangely enough, people hardly ever question whether sex without worries is really inherently bad and dangerous. Do you have to be paranoid to sense the persistence of a sexual morality that only accepts sexuality that reduces pleasure?
Even with PrEP, you take responsibility for yourself and others. And this aspect is also denied by PrEP critics with unwavering tenacity, as supposedly only the sacred condom stands for responsibility. The irrational root of the rejection becomes most visible when we look at how often the aspect of licentiousness is painted by PrEP opponents: They are so teeming with (sometimes suspiciously detailed) visions of "unbridled", "uninhibited", "wild" and "excessive" behaviour that the question occasionally arises as to what role envy actually plays in such comments. These comments are very clearly driven by the conviction that unbridled, unrestrained lust and responsible behaviour simply cannot go together.
The old issue of monogamy also comes up again: If there is any situation in which PrEP could be acceptable - perhaps even at health insurance costs - then it is the use within sero-discordant couple relationships, i.e. when one partner is HIV-positive and the other HIV-negative. Anyone who has already achieved the cachet of moral sexuality through monogamous self-discipline may not necessarily be expected to forgo additional pleasure by using a condom. (Of course, it's still only ideal if you're in a strictly monogamous relationship with an HIV-positive person undergoing treatment, using a condom and PrEP. It is precisely where PrEP makes the least sense that it seems most acceptable). In contrast to this, the idea emerges that PrEP, which is all too easily accessible, will further promote the bad habit of promiscuity - which "naturally" nobody could want.
So now we have the licentiousness, irresponsibility and promiscuity together again to condemn an immoral form of sexuality. The danger is still missing, but this is easily conjured up: Simply over-dramatise the minimal residual risk, contrary to all medical studies, paint the threat of resistance developing and the imminent flooding of the scene with other sexually transmitted diseases - voilà. The figures from studies that also included participants who took PrEP irregularly or not at all are often used to make the rock-solid claim that "the residual risk of PrEP" is over ten per cent. This even happens when a valid study has just been cited which confirms that PrEP has a lower residual risk than condom use. And if studies show that other STIs also become rarer when PrEP is given with close medical supervision - then you can simply deny this and claim the opposite. Behaviour that is "wrong" simply has to have negative consequences; not just for the perpetrators, but for society as a whole. And if the reality doesn't fit the moral image, then it is simply bent to fit.
The icing on the cake is the distinction between good and bad gays: all these discussions about PrEP with all the promiscuity, the emphasis on sexuality, irresponsibility, etc. are damaging the reputation of all gays and jeopardising all progress towards tolerance.
From this perspective, it seems quite obvious that promoting PrEP as a health insurance benefit is out of the question. Even if enough valid studies now show that in countries that make PrEP accessible at a low threshold, the number of infections falls significantly, which not only benefits the people who are no longer infected, but also the financing of the healthcare system: these facts cannot break through the emotional defence.
Frighteningly often I read comments in which the angry aggression against supposedly immoral sex without a condom extends to the demand that all people who are allegedly "culpably" infected with HIV should have the costs of their treatment cancelled - which would amount to letting most of them die miserably (and would also be madness in terms of prevention policy). The old longing for the just physical annihilation of immoral sexual behaviour is alive and well. And many gays have still not given up on it.
The astonishing persistence of sexual morals and fears has always been important for the development of our prevention and emancipation strategies. It is absolutely right to counter the irrational moral concepts that are wafting through our society and also through our subcultures just as stubbornly with the available facts. However, this alone will not be enough to break through the symbolic moral walls. Campaigns on HIV and PrEP must not only emphasise the medical facts, but must also focus on the problem of moral devaluations and combat these in the long term. We will not achieve greater acceptance for queer people, for HIV-positive people, for protection through therapy and for PrEP, in the community and in society, without working resolutely to overcome deep-seated old sexual fears. Fortunately, as far as I can see, this is exactly what is happening in some Campaigns is now increasingly taken for granted.
Wherever, on the other hand, the condemnation of supposedly "wrong" sexuality is affirmed directly or indirectly, in subordinate or main clauses, wherever various forms of consensual sexuality are devalued on the basis of irrational prejudices and we ourselves contribute to sexual paranoia - we have a huge emancipatory problem within our own ranks.
The demonisation of certain forms of consensual sexuality does not suddenly become harmless just because some of us manage to switch sides. It may be tempting to avoid stigmatisation by elevating ourselves morally above other, supposedly even more perverse people, e.g. as (supposedly) HIV-negative people above (knowingly) HIV-positive people, as people with a sexually exclusive relationship above those with open, polyamorous or promiscuous relationships or as condom users above PrEP users. However, as long as anti-sexual fears and aggression exist, they can change their target group at any time. This has happened several times, and it will happen again. As long as any form of consensual sexuality is demonised, no one is safe from suddenly becoming the victim of a new moral panic, including fantasies of extinction.
This text was published on 18 May 2018 in the blog "der zaunfink" and slightly updated here.
