Artist ········· Faysal Altunbozar
Medium ········· Text
Year ··········· 2019
Language ······· English


Recently I decided to get prescribed for PrEP, a daily-use antiretroviral that reduces the likelihood of HIV transmission.  I started writing about its potential to change the face of HIV and grant sexual liberation. The decision-making process led me to a reconsideration/reevaluation of the economic and political structures around my sexuality. The resulting text was suggestive of a personal manuscript - a compendium of facts, feelings, and thoughts I wanted to keep together. I decided to circulate the short essay as a single edition t-shirt label stitched to the inner surface of a plain t-shirt.

----- the text below will be printed on the t-shirt label and the photographs of the t-shirt will be exhibited on the website (text will be readable through detailed photos)-----

Two years ago I moved to Chicago for graduate school. The first place I stayed at was right on the beach and the room faced Lake Michigan. On the first day I arrived at my room around 8:30 pm. The sky blended into the body of water, a monochrome palette of blue framed by my window before me, the horizon missing. Emre started unpacking, and, unsurprisingly, my lazy ass laid down on the bed to take a deep dive into the Instagram-Grindr-Facebook wormhole. On the second scroll, a blue screen popped up on my Instagram feed.


Get your Prep on your phone

We accept most major insurances

Learn more” 

The blue was brighter than the sky and the lake but lighter than Jarman’s deep blue. That set the mood for me. The offer seemed convincing except forits sketchy design. There was no need to visit a doctor’s office, they would just send me an HIV home test kit, and if I were tested negative they would prescribe the medication. In Istanbul, PrEP was out of my reach; there were no ads, my insurance did not cover the expense, and the monthly cost of the drug was almost half of a minimum wage income. In any case, I don’t recall myself demanding it.

In 2017 researchers at Los Alamos National Laboratory, developed an algorithm capable of simulating HIV transmission across populations. The results are incredibly accurate and can be used to track down outbreaks within communities. The algorithm analyzes a data set of 840,000 HIV DNA sequence patterns and from which it makes its predictions. Data-driven marketing systems function in a similar logic with a different intention; generating profit through increasing demand. According to my harvested gay traces on the internet (accounts I follow, dating apps I use or my search history), the marketing algorithm predicted that I was in close proximity to HIV and I was a potential consumer of Truvada for PrEP. My body needed protection and this was a match made in digi-heaven. The machine was right, it studied my desires thoroughly and predicted my interest for the medication correctly. But one thing we both did not know was my eligibility for this service. I had no idea what the perks of my health insurance were, or if I even had insurance.

The offer was not exclusive to my phone. It insidiouslyappeared on my facebook page, on the streets of my neighborhood, in the train, at the bar. I was constantly alerted and reminded of the existence of and my own proximity to HIV. I was asked to “spread the love responsibly,” “play sure,” “be PrEPared for life” or "take it and get liberated.” The advertisements of these prescription services serve an educational purpose. Similar to the condom campaigns of the 80s and 90s they increase awareness for HIV prevention technologies. I did  some research and discovered that I had access to the medication. The only requirement was that I had to commit daily use.My insurance from school would cover it until the end of my education and after that, should I stay in the US and find a job that provides health insurance, my access to the medication will continue. If I decide to return to Istanbul, I might have to stop using it. You need access to certain  privileges; a steady job, health insurance, citizenship or a visa to gain access to be able to chemically colonize your microbiome and become a responsible cyborg who is immune to HIV. This is not shade towards modern western medicine, but towards its logistics. Although I am not sure if those two things are separable.

“You are confused” was the first reaction I got from my father when I accidentally came out of closet. I never felt confused about my own sexuality, but the bombardment of ads and information caused a strong turbulence in me. One side of me was interested in advancing my body beyond its natural capabilities with the help of this substance, the other side was not convinced considering PrEP as a sustainable option yet. I was discussing my dilemma about PrEP with Caroline, a straight female-identified friend of mine, who told me that after the decline of the epidemic, HIV was not a consideration in her daily routine. Recently, she was reminded of the ongoing epidemic by an unexpected loss of a close friend. He had lived with HIV without any complications for years until he decided not to take his medications anymore. HIV = Male Homosexuality is an inaccurate biological equation, but the virus and the disease cannot be culturally separated from gay identity. When the disease was first discovered, it was named GRID (Gay-Related Immune Deficiency), or the “gay plague”. Today we know the virus doesn’t have a sexual orientation, yet men who have sex with men are 83 times more likely to become infected.

The second thing my father told me in a rage about my sexual identity was, “Do you want to get AIDS?!” I got really angry at that time;I still believe it was a brutal thing to say to a 16 year-old teen, but instead of trying to prove he was wrong I will say yes, HIV is part of the gay identity. Beyond its biological presence, we, the queer community, inherited a trans-generational trauma. The melancholy of losing almost a whole generation is embedded in the culture. It is also an inevitable everyday reality. In the most literal way we are profiled-- after adding our height, weight, age, and ethnicity for our profiles on dating apps, we define our bodies by our HIV status . Options include: Positive, Positive (undetectable), Negative, Negative (on Prep). Which is also a data set (location + status) recently sold to two companies, Apptimize and Localytics, by Grindr.

It would be naive to assume we made our peace with the virus and the stigma disappeared. I am talking specifically about the queer community, the bubble. There are still people who have no idea that undetectable means untransmittable, or that being HIV positive does not equal a death sentence. HIV negative people are also not immune to the stigma. In the early years of PrEP, people who started using the drug were accused of promoting an immoral shared lifestyle. #TruvadaWhores were fucking raw, and gays who adopted heteronormative family values were upset. Since the medication became mainstream, tables have turned. If you don’t use PrEP and want to have protected sex you are being too cautious; a prude or ignorant.

Emre and I occasionally go to Steamworks, a three-story high gay bathhouse located in Boystown. A utopic plateau of pleasure, where you can get lost in mazes, let strangers touch your body and lose yourself in many orifices. In the early years of the epidemic, cruising spaces like this were the first implicated sites. Even though by the mainstream media they were framed as ‘cradles of filth’, they played an important role in sex education by promoting safe sex practices, HIV tests, and support systems for HIV positive people. On our last visit, we met with a six-foot tall British stud, strong enough to raise my body with just one hand. We started kissing in the steam room, he took me to one of the cabins, spread my buttcheeks, spit on my hole and pushed his cock in. He was a guy on a mission. I didn’t feel comfortable, took a condom from the container on the wall and offered him. He looked at me, shook his head no and continued pushing. I stopped him and offered the condom again. He sighed looked at me and said: “Babe, get on PrEP”.

A number of guys I have had sex with in the US insisted on not using condoms just because they were on PrEP. If I say no, the general reaction is between disappointment and mockery. They either question my knowledge of the medication or critique my decision to not to get prescribed. The other day I encountered Leandro on the street, I briefly mentioned this text I am writing and my thoughts on PrEP. He was a bit more skeptical of the drug and upset about it becoming almost like an obligation. We are both here as students from recently collapsed economies (the economy of Argentina collapsed as did the Turkish one) and we are both into dicks; a social, economic and sexual kinship. Not long ago a guy he had sex with called him to tell that he had tested positive for gonorrhea. He was on PrEP and convinced Leandro to have unprotected sex. Gonorrhea can be easily treated with certain antibiotics but getting a prescription is an issue. You have to pay for the medical examination, for the tests, and the drug. Based on the type of insurance you have, the amount you have to pay may vary. When you are avoiding even the smallest extra expenses it may not be an option to "not be uptight" about protection. When you are fucking, your government is also fucking with you. It is not fun because the deregulated privatized welfare system is impotent.

If used properly, PrEP is effective in preventing HIV transmission by 96-99%. A vitally important discovery and progress for members of at-risk populations. A liberation for HIV discordant partners, sex workers, queer bodies, all the promiscuous lovers & fuckers. But liberation comes at a cost. The production cost of one bottle, which covers the monthly use, is around $6, but patients are charged $1,600. Without health insurance it is not a feasible option. Gilead, the only producer of PrEP in the US, holds rights to two patents--Patent US6703396 B1 and Patent US6642245 B1, which prevents other companies from producing generic versions of PrEP and grants market exclusivity to the company. Patent protection is what allows companies to financially fund their research and development. However, counting on profit for medical innovation is a system that is designed to fail. Sexual liberation demands an economic revolution.

We live in the fourth decade of the HIV epidemic. PrEP has the potential to change our understanding of the disease. As a society, we have the tools but they are not distributed equally. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick, as Susan Sontag described. We prefer staying on the “healthy” side. In the pharmacopornographic era the border between those kingdoms eroded. It is not who is well or sick, or who tests positive or negative anymore, but who has the biopower. Who is allowed to adjust their biochemistry to live more comfortably within their body. After collecting a cluster of paranoias, I decided to use my access and get prescribed. I will be freed from the intrusive expectations of intimate strangers, freed from the paranoias that I have, and will have the power to test what technology can afford today. This is freedom with strings attached; I just became more dependent on my visa and the institution. I feel confident about my decision but this is the danger I am afraid of. Jarman presented us the universal blue. “Blue an open door to soul, an infinite possibility”. The lake is blue, the sky is blue, the blue is in my veins, but this blue is not universal yet. We will be liberated when fucking raw is not a privilege.

2019, The School of the Art Institute of Chicago