We have to work from an intentionally anti-capitalist lens and consider more complex, holistic solutions.


by Marq M. 

In July 2012, the U.S. Food & Drug Administration approved Truvada as Pre-Exposure Prophylaxis (PrEP). Simultaneously, there’s been increasing awareness around additional benefits of Highly Active Antiretroviral Therapy (HAART) as a method of preventing HIV transmission, as well as reinfection from other strains.

That understanding caught on to an extent that, in September 2017, the Center for Disease Control affirmed that an undetectable status makes it functionally impossible for people living with HIV to transmit the virus. This is also referred to as Treatment as Prevention (TasP).

RELATED: Learning to love myself enough to f*ck raw while Black and HIV positive

This has undoubtedly been a game-changer in navigating sexuality. Since the first cases of AIDS appeared in the 60’s, which swelled to an epidemic by the 80’s, there’s been extreme stigma attached to sexuality, on top of general, anti-sex stigma normalized via religious dogma and other trappings of colonialism. The introduction of TasP and PrEP have been crucial in helping many gain a sense of sexual empowerment that was previously hindered by the threat of HIV/AIDS. So, the gains made should not be downplayed.

That said, we need to have a more critical look at some of the language we’ve seen from some sex-positive circles (chiefly, middle class WhiteGayze™), which has tried to frame the current era of sexuality as a modern-day sexual revolution—a play on an era of the same name  from the 60’s through the 80’s. 

It’s perfectly understandable why some would frame it that way. For many, myself included, having better tools for HIV treatment/prevention has absolutely granted a freer practice in our sexuality that we didn’t have before. And to reiterate, this is progress worth noting and celebrating. But one major difference between today’s “sexual revolution,” and the 60’s, 70’s and 80’s, is today’s is only able to happen completely under the thumb of capitalism.

Today’s “sexual revolution” cannot happen outside of the strict terms set by greedy capitalists sitting in boardrooms. And the boardroom with the single most control over our sexual lives today is none other than pharmaceutical company, Gilead Sciences. 

This company has practically had a monopoly over the sex lives of many people for years. Gilead controls the production of the vast majority of medications most commonly prescribed for treating and preventing HIV. Their stranglehold over the very medications that are keeping many of us alive allows them to set whatever prices they want

This has raised many objections from HIV/AIDS activists because, in addition to the cost of production for these medications being far lower than what they charge, some of their most useful research was government-funded. How is it that taxpayers can fund such important research just for a private company to come in and make billions off of it? Short answer is: Capitalism.

Some cities and states have instituted programs that cover these medications for people who can’t otherwise access them. These programs are generally successful in lowering HIV transmissions. But this is a band-aid fix for a larger issue—that a single company has free reign to charge whatever it wants for necessary medications. 

These programs are also limited to parts of the country that tend to lean more progressive or liberal, and this leaves behind large populations of people who are also at risk for contracting, or even potentially dying from, the virus. So, while these measures are definitely a good thing, they don’t get at the root of the problem.

We also need to talk about the role of the prison industrial complex. In many parts of the U.S., there are laws where people who openly live with HIV risk criminalization if they’re accused of trying to “spread” HIV to someone else. These laws are a consequence of the epidemic at its peak and don’t reflect the realities of how we’ve come to understand HIV/AIDS today. 

One of the most visible examples came out of Missouri, where Michael Johnson, a young, Black gay man was sentenced to 30 years for not disclosing his status to sexual partners. The trial was long recognized as a sham. Thankfully, his charge was reduced to parole and he was released. He should never have been criminalized to begin with.  The laws used against Johnson are still on the books throughout much of the country and still put many people at risk.

Truth is, HIV criminalization laws do nothing to prevent the virus, and they’re actually counterproductive to prevention efforts. Plus, many of us living with HIV have talked about how the threat of criminalization—even while knowing there’s no risk of transmitting to anyone—still lingers in our consciousness. We can never really be 100% sure that someone might not try to weaponize our status against us.

Like with many forms of criminalization in a fundamentally corrupt system, these are laws that function to capitalize off of consensual human behavior via stigma and punishment…which only serves to reinforce the very harm it aims to protect against. Also, like with most anything else in this system, it puts Black people at higher risk. Because we’re both disproportionately affected by HIV and disproportionately criminalized by a system that functions to serve the interests of capitalism.

But a crucial, and oftentimes overlooked, aspect is that we tend to look at sexual health as a standalone issue, rather than fitting it into the larger system. People living in poverty are, not only far more likely to contract HIV, but are far less likely to seek care and treatment. Because capitalism inhibits people’s lives from virtually every angle, their ability and willingness to be on top of their sexual health can easily fall by the wayside if their most basic needs aren’t being met. 

Some still like to think the solution is as simple as making meds and HIV/STI screenings more widely available. But for many people living in poverty, they have a mountain of other issues going on that might prevent them from even getting to a place of worrying about HIV/STI’s. Obviously, HIV/AIDS/STI’s are pressing, if not life-or-death, issues for everyone. But if your reality is being uncertain of where your next meal is coming from, or if you’ll even be able to make rent for a given month, that makes it exponentially harder to be taking an active role over managing your sexual health. For many in this country, even transportation to get to the clinic is a roadblock.

Ultimately, we live in a system that still has limited (if any) access to comprehensive healthcare for many people, HIV/STI stigma that can still inhibit sexual health for those who are able to access care, and additional, structural barriers such as the education system and the prison industrial complex. 

So, as much as many would like to pretend the adoption of tools like condoms, PrEP and TasP (great and effective as they are), as well as the ongoing sex-positive movement, are leading us to some kind of “sexual revolution,” I don’t believe the realities of capitalism actually line up with the ideal that many have formed in their heads.

Truthfully, a real sexual revolution can never really happen under this existing system…but there are things we can do to help get us closer to that point. First is continuing to push for socialized healthcare, via policies like Medicare for All. Any politician pushing a healthcare plan that doesn’t specifically seek to transform the healthcare system from a capitalist product into the public good that it actually is, is not one who warrants support.

Also, pharmaceutical companies are charging exorbitant prices, purely because they can. So we also need to be pushing for policies that reign in what these companies are charging for prescription drugs.

Another structural change that needs to be made is a federal decriminalization of HIV. While I don’t expect the prison system, as a whole, to go away any time soon, it’s at least feasible to repeal archaic laws that needlessly criminalize people and exacerbate the problem.

RELATED: Reframing “sex positivity” by centering consent

In general, we have to work from an intentionally anti-capitalist lens and consider more complex, holistic solutions, because it’s not as simple as making screenings, condoms, or meds more accessible. While all of that is necessary, we also need to be addressing the overall well-being of a person (meaning, do they have stable access to good food, shelter, a living wage, etc). These are all factors that are relevant to one’s ability to not contract the virus, or live a long and healthy life with it.

If those of us with more sex-affirming politics are truly interested in a real sexual revoltion, that requires us first naming capitalism as the biggest roadblock to that happening.

Based in Chicago and a Louisiana native, Marq (a.k.a. Angry Black Hoemo) is a writer, activist and social critic. By day, he works in the technology field. Outside of that, he’s active in local organizing work and the Leather/BDSM community. He subscribes to a Black Queer Feminist politic, rooted in the core belief that everyone should be able to live in a world where they’re allowed the autonomy to be their full, authentic selves without opression. More writing can be found on his personal blog, angryblackhoemo.com.