In 2017, SPIT! (Sodomites, Perverts, Inverts Together!) — comprised of Carlos Maria Romero, Carlos Motta, and John Arthur Peetz— produced The SPIT! Manifesto Reader, an anthology of queer manifestos, dating from the 1970s to the present. The reader brought together key manifestos and other texts produced by queer activists and artists about sexual and gender politics. In addition to the historical texts, SPIT! wrote five new manifestos to address urgent contemporary queer issues. Amongst these manifestos is PrEP Manifesto (2017), a text that challenges, problematizes, and valorizes PrEP use by positioning it within a larger cultural, social, and political context. Below is a discussion between SPIT! members Carlos Motta and John Arthur Peetz to further elaborate on some of the statements put forth in the manifesto.

Carlos Motta: Last night, at R.’s, a sex party in a New York City midtown loft that has been running since 1996 and that advertises a policy of “sex with condoms enforced, zero tolerance for barebacking,” I was fully engaged with a cute and presumably very young top who wanted to fuck me. We clumsily dragged our aroused bodies to a couch where he turned me around to slip his cock inside me, followed by saying: “We are OK, I am on PrEP, I am clean.” What did he mean? What is OK? Are WE OK? What does he mean “CLEAN?” At “Gender Talents: A Special Address,” a symposium I organized at TATE Modern in 2013 (in collaboration with Electra), theorist and philosopher Paul B. Preciado made a critical exposé of regimes of power, from the 19th-century clinic, to the death of biopolitics, to what he’s termed the “pharmacopornographic” regime. At the end of his address, Preciado jokingly said: “When I see people that tell me, ‘Oh I am not going well,’ I say, ‘how can you go well? You have three regimes of power that are completely working against each other within your body!’” At the risk of being a boner killer—even with Paul B.’s words rapidly flashing through my mind—I opted not to get into it with my top and instead told him, “Use a condom, I am here with my boyfriend and I don’t want to give him anything.”

I am on PrEP, too; in fact, I was patient number twenty-one at Callen-Lorde’s initial PrEP study back in 2013 and have taken Truvada 200/300 mg, as treatment as prevention, daily since. I have had five years to consider the effects that the PrEP regime has had on my psyche, my social body and sexual relations, and my relationship to the HIV/AIDS infection. I was a teenager in the 1990s, and until 2013 the specter of infection haunted my sex life. An orgasm was always followed by an imminent image of death. Did the condom break, did he come in my mouth? In the last five years, as I take Truvada, this paranoid equivalence of sex and threat has disappeared. There is an undeniable beauty to fucking without condoms and to surrendering to my uncensored desires, yet PrEP is about so much more than my sexual enjoyment: PrEP represents a medical, social, cultural, and political shift that defines sexual subjectivities in a profoundly unequal neoliberal world economy where financial profit precedes pretty much anything else. 

Last year, a year into us dating, you and I wrote PrEP Manifesto, a manifesto where we laid out a set of thoughtful statements about PrEP. For this exchange, I propose we dissect together some of the lines we wrote, to reflect on this new landscape of pharmaco-mediated subjectivities and how, in fact, one could argue that PrEP, today, is not about AIDS:

Because PrEP has been hailed as a victory for the assumed “end” of the AIDS epidemic  

NIAID, Pre-Exposure Prophylaxis (PrEP), 2016. Wikimedia Commons, the free media repository.

John Arthur Peetz: I wouldn’t just support the argument that the discourse around PrEP is no longer about AIDS for those who take it, as well as those who market, distribute, and manufacture it. I would go as far as to say that the modern “pharmacopornographic” regime (borrowing from Paul B. Preciado) and its miracle pill, which I also take daily, is actively contributing to an erasure of the legacy of AIDS activism as well as an erasure of the concerns that affect the people who are still most disproportionately affected by the virus. I think we can look at this perceived “victory for the assumed ‘end’ of the AIDS epidemic” as creating the conditions necessary for a vulnerable, and at one point radically politically engaged community, to distance ourselves from the struggles of those without health care or who live in regions where the PrEP regime hasn’t been made available. Looking at this preventative regime of medication as a “victory” distracts us from the actual reality of the rates of infection in marginalized populations who can’t participate in medical trials and testing. One of the most undeniably fascinating strategies of resistance born from the legacy of HIV/AIDS activism was the shift from accepting assumed scientific truths about diseased bodies to an active re-engagement with the construction of subjectivities via direct action and the changing methodologies of self-administration and self-care. As your sex party anecdote demonstrates, what we seem to have now is a community of bodies on AIDS medications, some living with the virus in their bodies, some not, whose active engagement consists in the consumption of pharmacology and a willful disengagement with the hard-won agency that AIDS activists fought to secure.

Because we are the survivors and the inheritors of a plague that has killed millions

CM: There are profound differences between those who died of AIDS-related complications in the 1980s and 1990s and those who survived those initial years, those who came of age after the AIDS Cocktail was introduced in 1996, and those who have access to PrEP today. For each of these groups, the stakes are so high, so different, so layered, and so fraught with contradictions. Yet we are all, as we say in the manifesto, the survivors and as such, we are all responsible to the dead and to the activists and caretakers who put their bodies and livelihoods on the line to save our lives, to fight government inefficacy and cultural stigma, and to reject all the other forms of abhorrent discriminatory and ignorant behaviors in regard to the HIV/AIDS crisis. Yet, we can’t expect people today to carry the burden of the past generation on their shoulders and to live in a perpetual state of mourning. While there is a part of me who wants new generations of queers to know the history that has made it possible to forget, there is another part of me that thinks this naïveté is a form of liberation they are indeed entitled to. In regard to this, I often think of Walter Benjamin’s beautiful “the angel of history” in On the Concept of History (1940):

An angel is depicted there who looks as though he were about to distance himself from something which he is staring at. His eyes are opened wide, his mouth stands open and his wings are outstretched. The Angel of History must look just so. His face is turned towards the past. Where we see the appearance of a chain of events, he sees one single catastrophe, which unceasingly piles rubble on top of rubble and hurls it before his feet. He would like to pause for a moment, to awaken the dead and to piece together what has been smashed. But a storm is blowing from Paradise, it has caught itself up in his wings and is so strong that the Angel can no longer close them. The storm drives him irresistibly into the future, to which his back is turned, while the rubble-heap before him grows sky-high. That which we call progress, is this storm.

But if “progress” is an ever-present storm of inequality, classism, racism, and patriarchy, political neoliberalism, market capitalism, pharmaceutical control, patents, and greed, how do we continue to resist in the midst of an illusion of progress? How do we honor the dead, fight back, and live freely in the present while facing these destabilizing contradictions?

Because PrEP is the product of the years of labor of AIDS activism

JAP: It is foolish and perhaps even draconian to think that the PrEP generation should fuck with the specter of an epidemic hanging above their heads. But there is a troubling compliance and unexamined consumption that goes along with not understanding the historical labor of resistance and activism that brought us to this current medicated state. Let’s consider that HIV/AIDS activism was not only important because of the lives that it saved, but also because it represented an epistemological shift in redefining the engagement with the micropolitics of identity and dissent. Now let’s examine the fruits of two decades of activist labor. On one hand, we have an empirical and scientific product: an effective drug cocktail, the reallocation of state funding, and PrEP. On the other hand, we have the genesis of treatment activism: an engaged population that successfully and in a self-directed manner transformed themselves from “victims” to chemists, administrators, and propagandists, forming new political subjectivities. Campaigns such as the “Open The Pill” call to action, asking patients to examine and know the content of the medication they were ingesting, exerted a double pressure to stop the bureaucracy of scientific truth trials through placebo studies and asserted an active role in the decision-making process around HIV/AIDS medication and treatment. I would argue that part of the reason why PrEP is not about AIDS, is precisely because of a lack of engagement in that consumptive process. We are no longer asking to be in charge of constructing ourselves as active pharmaceutical subjects, rather we are passively allowing ourselves to be constructed as consumers and test-subjects.

Because PrEP embodies at once the liberatory sexual ethos of the pre-AIDS crisis while retaining HIV/AIDS stigmatization of the ‘80s, ‘90s and 2000s

Britney Spears. untitled, 2017. from instgram

CM: It is important to keep in mind the immensely positive effects the PrEP regime has brought around, like making sexual relationships between zero-discordant people less risky, enabling sex workers with access to PrEP less vulnerable to recurrent exposure to the virus and infection, and encouraging a more open conversation about HIV status between HIV-conscious sexual partners. Because of its unprecedentedly high success rates, one could argue that PrEP has also liberated sex from fear, producing a kind of renaissance of sexual freedom similar to the mythical 1970s. In countries where PrEP has been regulated by government health systems, subsidized by health insurance, or where Truvada as PrEP is available for purchase with a medical prescription, I have experienced a complete shift in sexual behaviors, where for example, barebacking, getting loaded, and swallowing cum are now unexamined and completely accepted practices. I have had many conversations with sex partners, friends, and random hook-ups about the ways in which our relationship to HIV/AIDS changed so fast, from a constant meditation on mortality to an emancipatory, if somewhat careless, freedom to fuck whoever and as many people we want. In this regard, PrEP is also not about AIDS; it is about a change of attitude towards sex in general, where HIV infection isn’t a point of contestation or even something people think about often. This is rather paradoxical: How is it that people take an HIV medication daily and never consider HIV? Voluntarily taking a pill everyday as a preventative measure has dissociated the virus from the medication in people’s imagination. Perhaps the distance between a medicated body and a diseased body is the new condition of our time.

HIV-positive friends, however, continuously tell me chilling stories of discrimination, where upon disclosing their status to sexual partners, they are rejected and ostracized. While HIV-undetectability and PrEP have given HIV-negative people more tools to prevent infection, HIV-positivity continues to produce a fear that is deeply rooted in the media-medical discourse of the 1980s, 1990s, and 2000s. The socially constructed fear of what Larry Kramer famously referred to as “a plague,” manifests itself as an acute stigma that even a medical breakthrough such as a preventative treatment like PrEP doesn’t seem to eradicate.     

Because PrEP is a deal with the devil of capitalism and the devil likes to barter with the privileged and affluent first

JAP: I have been thinking a lot about stigma and its pervasive staining presence in the social mind in terms of the continual criminalization of people who spread HIV or self-define as bug chasers. Recently, within our larger friend group, we learned that someone was infected by a partner who had knowingly kept his positive status a secret. It turns out that not only had this happened to our friend, but that this person had done this to several other people around the country and even had a police record of criminal transmission; wherein the disciplinary framework defined the act as “assault with a deadly weapon.” It is a bizarre and perverse legalized Aristotelian transformation to have a human body with HIV legally defined as a deadly weapon. As much as a gun has the potential to be a deadly weapon, can we also apply this logic to an infected person? Ultimately, the friend who was infected sent a text to many of his acquaintances denouncing this person and warning other people who may have had sex with him to get tested/beware and is currently pursuing legal action, unintentionally reproducing and buttressing this stigmatization. While knowingly infecting someone is repugnant from the outside, there is still much we don’t know about the specifics of this case, including what treatment this man thought he was getting or even if he was adequately informed about his status and his viral load. Texting others, while obviously was nobly intentioned to warn a community and to correct the wrongs done to several individuals, ached of panic and disgust as articulated through concern for public health. I worry that the barbaric machines of the massive prison industrial complex and systemically biased criminal justice system are not capable of dealing with the politics of disease and desire and only serve to reinforce stigma and prejudice. Furthermore, it forced me to ask myself how and why. How has PrEP changed conversations about status and safe-sex or even elided conversations about sexual health and HIV in the first place? Why is criminalization the only option we are given to rectify this?

I am not anti-PrEP nor am I interested in shaming “Truvada whores,” doing so would be hypocritical. But I am aware of the persistent contradictions and limitations in universal treatment that are taking place. PrEP exists; safe condomless sex is a reality; people are dying from HIV/AIDS-related complications at a much lower rate; but HIV/AIDS is still a health crisis that is not under control, and this battle for treatment and access is definitively racialized, economic, and geographic. We must consider that the conversation about HIV/AIDS is global and spans the gender and racial spectrum, but the conversation about PrEP is still regional and is isolated primarily to the developed West and the Global North. While I acknowledge that a significant effort has been put forth to include women and people of color in the conversation, it must also be acknowledged that the battle for global access is dictated by pharmaceutical companies that monopolize patent laws and control the production and distribution of generics, causing the drug to be prohibitively expensive. I am not saying that pharmaceutical companies and nation-states are in collusion globally over HIV/AIDS preventative medication, but I find it important to remember that many medical and pharmaceutical breakthroughs have historically been paired with a troubling moral and scientific eugenic trajectory that begs us to examine the correlation between populations that are most affected by HIV/AIDS and populations that are the most disenfranchised or subjected to civic violence, be that disciplinary, medical, sexual, or economic. We are at historic level in HIV/AIDS treatment, but we have so much further to go, to reframe our activism and our demands for access to treatment, if we truly aim at eradicating the virus and its stigma.

Because our desire is the backbone of our communities

@americasnexttopbottom, untitled, date unknown. from Instagram

CM: Back in 2014, I had a conversation with Nathan Lee titled “There is Tremendous Ferocity in Being Gentle” for “Time is Not A Line: Conversations, Essays, and Images About HIV/AIDS Now,” an issue of the We Who Feel Differently Journal edited by Theodore (ted) Kerr. Amongst the topics we discussed was what I then expressed as an irrational desire to have condomless sex, a word Nathan challenged as a curious choice. At the time I had just started taking PrEP and my perception of sex was tainted with shame and fear; barebacking seemed to me in many ways like an act of narcissism that denied our community’s history and relationship to AIDS. At some point in the conversation, I asked Nathan: “What if I don’t care to honor the victims of ‘the plague’? What if I choose to ignore the economic politics of the pharmaceutical industry and give myself to individualistic pleasure? What if my notion of care is different? What if, what if, what if?” The PrEP regime has blurred all these questions in my personal and social experience of sex. Yes, I have given myself unapologetically to “individualistic” pleasure, but my notion of care has heightened; I am committed to pushing back against stigma, and I am more aware of the politics of inequality around health care; I feel I am part of a community that is split around access to PrEP, yet I fear no more for my health or the expression of my desire.

Returning to R.’s sex party I mentioned above: R. started his party in the midst of the AIDS crisis partly in response to his lover’s death due to HIV complications and wanted to start a sex party that was more responsible and safer in light of his experience being a caretaker. In a way, R. literally articulated with his sex party some of Douglas Crimp’s most important points around how to live promiscuity and express our community’s desire within an epidemic. He has sustained a large orgy for 20+ years in honor of the dead, promoting safe sexual practices while celebrating debauchery: because our desire is the backbone of our communities, it is both our greatest asset and our biggest challenge in this patriarchal and homophobic world. 

Ours is a post-PrEP relationship, and I have really enjoyed our sexual openness and explorations together. We are both careless and critical, we have built an army of lovers and desire that is intimate and social. I am also happy that we have done all this understanding the history that brought us to this point. It is an interesting time we are living in.

This exchange took place in April 2018.

Carlos Motta’s multi-disciplinary art practice documents the social conditions and political struggles of sexual, gender, and ethnic minority communities in order to challenge dominant and normative discourses through visibility and self-representation. As a historian of untold narratives and an archivist of repressed histories, Motta is committed to in-depth research on the struggles of post-colonial subjects and societies. His work manifests in a variety of mediums including video, installation, sculpture, drawing, web-based projects, performance, and symposia.

John Arthur Peetz is an art writer and book editor working in New York City. He has written for Artforum, Art in America, PIN-UP, and DIS Magazine. He is currently in the process of writing a book on HIV/AIDS, Activism, and Performance Art in the Global South.