World Aids Day: Antiretroviral drug sets you free
PrEP reduces the risk of HIV by over 90% if taken every day at the same time
Skin on skin was once the forbidden fruit of male casual sex hook-ups, but that is all changing, thanks to a blue pill.
That large blue pill is an antiretroviral drug called Truvada and it reduces the risk of HIV by more than 90% if taken every single day at the same time.
"Love has no boundaries ... it doesn't matter," is the way Thembelani Sibanda, 29, explains how he would consider an HIV-positive male partner now that he uses the preventative pill.
Sibanda laughs a lot as he talks. We meet in Soweto, which is the township he says allows him to be who he is today: an openly gay man, openly taking a pill at 9 every night that reduces his risk of contracting HIV.
The pills he takes are often referred to in the HIV community as PrEP, a short form of the term pre-exposure prophylaxis.
Truvada and its generic equivalents, are registered in South Africa as a preventative measure for people at significant risk of HIV acquisition.
However, while admitting he doesn't always use them, doctors usually encourage all people using PrEP to use condoms as sexually transmitted infections can be spread through unprotected sex.
"Sometimes condoms are irritating," Sibanda says honestly.
Anova Health Institute doctor Kevin Rebe said: "Because he does not always use condoms, he has chosen the best strategy to avoid sero converting (becoming positive). This is proactively doing something. Because he is using PrEP, he will be screened for other sexually transmitted infections every three months [at the clinic]."
Sibanda is HIV-negative. He is a Zimbabwean who has been in South Africa for 10 years and works at an NGO with youth almost like a "social worker".
Sibanda has regular HIV tests and has kidney tests to ensure no damage is caused by the pills.
Rebe explains: "The preventative drug is being made available by Anova in a partnership with the Department of Health to men who have sex with men, at three clinics: one in Hatfield, one in Yeoville and one in Cape Town. It will be made available to two Soweto clinics next year. There are 11 sites for sex workers to get PrEP countrywide and various demonstration projects to see if adolescents and young women are interested in using PrEP as an HIV- prevention option."
The pills are being put on trial at seven university campuses to ascertain if students who are at high risk of HIV will choose this form of prevention, along with condoms.
"People see you taking them and they think you are HIV-positive but it doesn't bother me," says Sibanda.
He has been on ARVs for prevention of HIV for five months.
"It's like eating," says Sibanda as he explains the ease of popping one pill at the same time daily. He wants to reduce his risk of the disease, even though he is single for much of the time.
"Gay life is fast. You may meet up on Facebook and have sex the same day or you meet up in a club and have sex in the toilets."
He is taking four people to get the drug at the clinic in Yeoville in a few weeks.
"The festive season is arriving," he says.
During Johannesburg Gay Pride at Melrose Arch, Sibanda wore only a speedo and covered himself in blue paint to represent the blue preventative pill.
He also has conversations with straight men who secretly have male partners at night. He calls them "heteroflexibles", men who would never be identified as gay, may have wives, but approach gay men discreetly.
Part of Sibanda's openness about using PrEP comes from eventually deciding to come out of the closet as gay in 2010.
"I felt like a baby crying inside. When you are at home you are someone. But when you go out, you are someone else.
"Eventually I was like: Yeah no, let's come out of the closet."