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The Postscript: Alexander McClelland speaks to Anthony Oliveira about PrEP

In his Spring 2019 story "Unprepared," Alexander McClelland explored the culture shock that has come to the queer community with the advent of PrEP, the drug that prevents HIV transmission. PrEP has a cult following, McClelland writes (“PrEP-themed merch includes, but is not limited to, T-shirts, posters, key chains and tote bags”). But he asks if the drug has actually brought this much-hyped revolution, or whether it's just allowing the erasure of a painful past.

Here, he speaks to Anthony Oliveira, a National Magazine Award-nominated writer, film programmer, pop culture critic and PhD, about the piece and its reception.

Anthony Oliveira: First of all, thank you for this piece; it has come to me at a very specific moment in my life. I’m coming out of a long-term monogamous relationship, and suddenly you look at these [hookup] apps and realize, “Oh, everyone is talking about their PrEP status.”  

And I was really struck by the moment in which you mention Casey Spooner’s image of Truvada as the “New Testament.” I was like, well, what does that mean? Because if it is a New Testament, then in some ways you and I are not qualified to understand it, because we come so much from the older world. What do you think of when you look at that New Testament piece?

Alexander McClelland: It initially frustrated me and made me angry. My brain is programmed in a certain way based on how I've grown up.

AO: Exactly; I don't think I believe in God, but my brain insists upon perceiving the world through this sort of colonized Christian lens. And you and I have been installed with this architecture of fear, no matter how much we may intellectualize it or you may have to theorize it for your work. Before I understood anything about my own sexuality, about what AIDS was, I knew to be afraid of it. And I knew to be ashamed of the sex that could lead to it. I can't uninstall that no matter how hard I try. I cannot get rid of that.

We talk about the importance of memorial, remembering the trauma of that history, but we're entering a period where we have to communicate that trauma because people who are coming up don't have any of it and maybe never will.

AM: I tested positive so young and right when I tested positive, I learned about HIV criminalization. So I've never understood my sexual life as an adult outside of the parameters dictated by the police and the criminal justice system. And just the fact that that could change for people is beautiful and amazing, and would be great. But there's the lack of sexual autonomy that positive people have had for so long.

The kind of sexual exhibitionism that came with the launch of PrEP—that certain people have—made me uncomfortable. It made me uncomfortable because it's privileging this one thing over so many other things. And I think it's excellent that gay men should feel entitled to have beautiful, open public sex lives, but that one pill isn't a solution to it all. There are so many other problems going on, and it glosses over a lot of them.

AO: Your piece also put its hands on just how classed an issue this is. I'm a freelance writer; I have six jobs and none of them have the health care attached to them. [Paying for PrEP] would literally be like paying my utilities twice every month. And that is just a barrier. This is for white, wealthy gay men. And what's interesting to me is how much PrEP almost emerges as a party drug in your piece. What was supposed to be this sort of liberational gesture is actually a really specific leisure class in the Global North. To see these pharmaceutical companies thriving and to see how raced so much of this is very illuminating to me.

One of your interviewees in the piece says: “What would it mean if we started taking the fear of gay men seriously?” And then you agree, but you didn't answer the question. What would it mean to take it seriously?

AM: Well, your recent work [about the Bruce McArthur sentencing] is about the fears of gay men not being taken seriously as well. It’s just in a different realm, right? And that has very real consequences. People were murdered. In so many aspects of society, the feelings of gay men are marginalized. And I don't know what it would mean, because it's never happened.

AO: What strikes me about it is that pieces like yours, and maybe like mine, aren't supposed to exist because they ask questions and don't provide responses. I feel like the queer community is never supposed to think out loud; we're always supposed to present the solution so that the straight people understand what we want. I think that that has happened with PrEP. It's here—the silver bullet has arrived—and the conversations you open up are not allowed to occur because they open up a flank; it becomes possible to say, for example, if conversations are happening about whether OHIP should cover PrEP, people can point to what you wrote and say this is why we shouldn't. You become a tool for more conservative voices to deny us.

AM: Exactly.

AO: Which is even a fear you acknowledge in your piece, right? And by damaging this type of advocacy on behalf of a different type of advocacy, you're imagined to have depleted a resource, which I also felt with my piece. It's like, well, now the police have a way to hurt us. When I published that McArthur piece, everyone was like, “Be careful; the police are gonna come after you.” Which is laughable; what are they going to do that's worse? They're going to let people get killed for seventeen years?

But I think that your demand for a conversation in itself makes people nervous.

AM: Yeah. Sarah Schulman [a writer, academic and AIDS historian] emailed me afterwards, and she said one of the reasons she appreciated this piece is because I wrote as an HIV-positive person with soul and depth and put that out into a society where there is no voice for HIV-positive people in public life. That's one of the things that I was trying to do. So that’s exactly the question: can we have a conversation with nuance and complexity that isn't didactic so that straight people understand it? And some people don't want to hear that, or don't want it to allow for it to happen.

AO: What was the genesis of the piece? It seems to make its locus that sex party. Is that where it started?

AM: I initially never thought that I would talk about PrEP at all. It wasn't something I wanted to write about. Throughout my entire life [as an HIV-positive person], I have been conflicted about HIV-prevention stuff. It's constructed me as someone not to be, or someone to be scared of. So with PrEP, initially when it came out, I felt the same way. I was like: this isn't for me, and why aren't people talking about HIV criminalization or treatment access for people who already have HIV? But Maisonneuve reached out to me and asked me to write about it, and I eventually decided to, after being encouraged by a few people.

AO: I'm really taken by the piece's structure—part memoir, part journalism. How did it take shape?

AM: I guess I started thinking about the ways in which my life intersects with people who are using PrEP. Often I had stayed away from sleeping with [HIV-]negative men. And then I had started to more and more, as things have changed with medication treatment. And so I wrote a bunch of vignettes about how my life has intersected with PrEP in various different ways. The sex party was one of them, and dealing with people online was another very common one. And then I started sleeping with this guy who's on PrEP, which was confusing and bizarre to me.

And so I realized that PrEP did impact on how my sexual life was organized—I just hadn't really acknowledged it. The piece was structured in a way to bring out those complexities. I wanted to talk about nuance and complexity where that hadn't been allowed to happen. It was just this dichotomy: either you're for PrEP or against PrEP. And if you're against PrEP, you hate gay men, you hate yourself, and you hate sex. I think it's much more complicated than that. I'm not against PrEP, but I wanted to have a conversation about it that had depth.

AO: The writing is so personal and yet in reading it, except for half a phrase, you would not know about the work you do day to day [as an academic researching HIV]. How much did that inform the piece?

AM: A lot of my work is about sexual autonomy and my whole dissertation is about HIV criminalization. I interviewed people who have been criminalized, who are now sex offenders, whose lives have totally been destroyed by the Canadian criminal justice system, all because they have HIV. It's very important to the piece.

AO: Since it was published, have there been criticisms? Was there like a wild pitchfork moment?

AM: There were a couple of pitchfork moments, yeah. I was worried about some people reacting like I wanted to take their PrEP away. And that's not what the piece is about, but there was some Twitter freakout at me—or at the piece—and kind of shaming people in the piece like Ted Kerr, who I quoted as saying, "I'm an HIV negative man who doesn't take PrEP." I think some of the negative reactions were people projecting the kind of dichotomy that I just mentioned onto the piece, when I don't think that was there. We tried to be quite delicate. I am pretty obvious in my disdain for the PrEP rhetoric in the piece. And I kind of maybe wish that had been toned down a little bit, but also, I don't really care.

AO: It's funny that you say that, because I didn't find that at all. I felt like the controlling energy was sort of like a low, low-grade anxiety. It was very good about putting its hands on the pressure points of the issue and just being like, “Have you thought about this?”But other than this sort of gesture at the end of this utopian conversation, I don't know what your prescriptions are. What is your utopia here? I'm not asking for solutions, but what would you like to see corrected?

AM: I was talking to someone about that, because I do make a gesture towards the past—or a bunch of gestures— because I'm kind of stuck in the past.

AO: Yes, describing cruising as utopia is an interesting choice, I thought. I was like "Oh, that's what trying to get back to?”

AM: Sarah Schulman said that—“Alex, you're making this gesture to the past of sexual liberation amongst gay men. I just want to remind you that that came from a broader sexual movement of ‘Black is beautiful’ and feminist liberation, and it's connected to all these other things.” And the sexual anxieties that we see today are not just exclusive to gay men. We live in a corrupt society with the sexual violence that led to the MeToo movement, everyone is having fraught sexual relationships, not just gay men.

I don't think my prescription is to go back to the past. A couple of the critiques were about me romanticizing the past. And I was not trying to do that. I don't know if I have solutions, and that's what I wanted to steer clear of. The one prescription or utopia came from what Ricky Varghese said, which was that we’ve assigned too much meaning to PrEP. It could be cool if it was perceived as just one option amongst many that we can use, as opposed to this silver bullet.