Erika and I have been wanting to do an HIV, AIDS, PrEP comic for yearrrrrs, but always felt like we needed an expert closer to the subject. Fortunately, Silver is here today to share with us his fantastic comic that does a great job of breaking it all down, far better than we could have. This was a huge project and I think it turned out just amazing.
Check out the links below for more info, but keep in mind there are different rules with regards to the recommended use of PrEP in the US, as compared with the rest of the world. We also did a comic about getting an STI test here!
Go drop Silver some silver! Or at the very least, some nice comments:
Further Reading
► What is PrEP?/¿Qué es PrEP? (Short video!)
► The Real Deal On HIV, PrEP, and PEP via Scarleteen
► The STI Files: Human Immunodeficiency Virus (HIV) via Scarleteen
► Positively Informed: An HIV/AIDS Roundup via Scarleteen
► PrEP and HIV via Planned Parenthood
► hiv.gov
A cartoony drawing of a white man is introducing himself saying, "Hi! My name is Silver, I'm a French cartoonist and I volunteer and work at the French Planned Parenthood." He is holding a bunch of drawing utensils in his left hand and in his right is a picket sign reading "SMASH THE PATRIARCHY". As he happily tosses blue pills into the air like confetti, he announces, "I'm also a polyamorous gay guy who started taking PrEP last year!"
Silver narrates over a flashback of various sexual encounters he's had, all while looking anxious or worried. "Being on PrEP has changed how I experience sex. It's lifted a weight I didn't even know I was carrying." In his flashbacks, he worries to himself, "What if the condom breaks? Remember that article on that guy who caught HIV with a blow job? Do we REALLY trust this guy?? Did you see the ratio of infected gay men? It's only a matter of time!"
Present day Silver returns, saying "HIV was always there, in a small corner of my mind, haunting me. And information and PrEP has helped free me from that."
Page 2
Silver presents the floating titles "HIV Human Immunodeficiency Virus" and "AIDS Acquired Immune Deficiency Syndrome" while narratting, "So let's get into it! I'm here to talk about HIV, AIDS and PrEP! First and foremost, the important thing to know about the big and scary HIV and AIDS, is that they are not the same thing. HIV is the name of the virus. And AIDS is the name of a condition, caused by HIV. One of the most important parts of our immune system are our CD4 cells which are also known as white blood cells. These cells fight against all kind of infections."
We are taken inside a vein, first showing us blood cells with determined eyes who are glaring down a monstrous yellow cell with evil-looking eyes, teeth, and tentacles. The red blood cells declare, "You shall not pass!" at the invader. Then we see red blood cells that have been infected (they have hollow, zombie-like eyes now, and brown spikey clusters in their membranes) and are splitting into more copies of themselves.
NARRATION: What HIV does is that it infects and hides in our CD4 cells. Making it impossible for our body to find and fight. These infected CD4 cells become ineffective, but they still multiply to fight attacks, which helps the HIV multiply too!
An man in boxers stands among the following narration. From his boxers upwards, he is colored red. From below his boxers down to his feet, he is colored teal, and the number 600 is written on him- denoting his CD4 count.
NARRATION: Treatment for an HIV-positive person is all about the CD4 count, measured via a blood test! You WANT a high count of effective CD4 cells to fight off infections, while a low count means the HIV has rendered too many CD4 cells useless, making it more likely you'll not be able to fight other kinds of infections. A normal amount is usually between 500 and 1,600. But things starts to go really bad under 200. At which point you're considered to have AIDS*, and you're in scary territory where even a cold can be a life risk. *According to the US Centers for Disease Control.
Page 3
A very worried person asks Silver, "OK. So what do I do if the HIV test comes back positive? It's... incurable, right?"
Silver answers reassuringly, "Unfortunately so. BUT there are so many ways to deal with it. Being diagnosed with HIV is not the death sentence it once was. Nowadays, you can live a long and normal life, even with HIV.
Over an image of a worried man consulting with a happy medical practitioner, the narration reads, "The most important thing to do when you discover you're HIV-positive is to go see a doctor as quickly as possible, to discover your CD4 cell count, and start an Antiretroviral Therapy (ART). The sooner you start the treatment the better." The text continues over an illustration of a confident young man who is looking at a collection of over-sized pills that are floating around his head. "ART is a mix of different HIV medicines and the regimen will depend on your CD4 count, your medical background and other particular needs. To each their own!"
NARRATION: Generally, ART helps lower the amount of virus in your system by hindering and getting in the way of how it grows and proliferates in the body. It gives your body the chance to increase its CD4 count so you can put up a better fight against other opportunistic infections.
IMAGE: Back inside a blood stream, we see big beefy red blood cells staring down a smaller invader who looks scared.
SILVER: Hopefully, within a matter of months of the right ART treatment, the virus should be restrained and the viral load should drop so low that you'll become undetectable!
Page 4
The nervous guy from earlier asks Silver, "Undetectable?" to which Silver reassuringly responds, "Yup! Through the years of the AIDS epidemic, we discovered that a person can get a viral load so low it becomes undetectable through tests, and essentially untransmittable! They aren't cured, but through dilligent use of ART, they've pushed the virus back so much it doesn't even show up any more."
NARRATION: That's why it's SO important to begin a treatment as soon as possible and to know your viral load and CD4 count.
A different little dude is holding a letter with his results on it while he exclaims, "Yes, finally!"
NARRATION: With that data, treatment and follow-ups, it can take only a few months before a HIV-positive person can start having the sex life they want without fear they'll transmit HIV!
IMAGE: A hairy man happily reclines on his back while his partner buries his face between his legs. Lots of hearts float around them.
NARRATION: It's called "Treatment as Prevention" or TasP for short.
NARRATION: It still isn't a cure, and even when you're undetectable, you'll need to keep taking ART for the rest of your life.
IMAGE: A person from the shoulders-up stars into the distance in profile with a constellation of pills orbiting around his head.
Page 5
Worried guy again, "Sooo... does that mean if I'm negative, I can have unprotected sex with an HIV-positive guy or make out with him without being infected, if he's undetectable?"
Silver cooly replies, "Well, friend, you can kiss whoever you want, regardless of their status or viral load, HIV is NOT transmitted by saliva, just blood, precum, ejaculate and vaginal secretions. But yeah, otherwise TasP is as effective as PrEP or condoms with regards to HIV. But keep in mind PrEP will not protect you from other STDs!
CAPTION: One Week Later
The formerly worried guy now approaches Silver looking happy and carrying a folder of his medical results. He says, "I finally got tested, I'm negative! But now, I want to know, what is the best protection against HIV?" Silver replies, "Easy, the one that suits you best!"
Surrounding the narration are illustrations of a regular condom and internal ("female") condom.
NARRATION: Oldie but Goldie: the condom! It comes in his external or internal format, in latex or in nitrile, in different sizes, shapes, tastes or colors and when worn properly, it'll protect you from bodily fluids that might possibly transmit HIV or other STDs!
An illustration of blue pills accompanies the text, "Then there's PrEP! Short for Pre-Exposure Prophylaxis, it is a treatment plan of a cocktail of antiretroviral drugs that HIV-negative people who are at a higher risk of exposure can regularly take to protect them from the virus!"
Now we are back inside a vein where a cluster of confused invading viruses are stopped by a big sign reading "DO NOT ENTER" which is accompanied by a resolute-looking blue pill who has crossed arms, and behind him are burly, confident red blood cells who smile intimidatingly at the viruses. Above them the narration reads, "Then, if exposure to HIV occurs, the drugs stop the virus from entering cells and replicating, and the person remains HIV-negative.
Page 6
Next to an illustration of the earth, the narration reads, "Right now (2018) in the United States, you have to take PrEP on a daily basis (in some other countries you can choose to take PrEP 'On demand' "
Inside a doctor's office, a happy patient shakes hands with their medical provider in their office. The narration reads, "To begin the treatment, you have to go to a doctor, nurse, or to your local Planned Parenthood to talk with them about your sex life, medical history and then take some HIV/STD tests to see if you're negative before starting the treatment. After a few days on PrEP (usually 7 days), you should be covered! Also, PrEP *always* comes with a mandatory medical follow up every 3 months so you can get tested for other STDs and check on your sexual health in general!"
A side note follows up, "The use of PrEP changes according to the country you live in. Some countries like France have universal healthcare so PrEP is totally free, and in others like the United States, it will depend on your insurance. Good to know: there are also organizations that can help you pay for PrEP if you have no insurance!"
The confused guy from earlier is again confused, asking, "Wow... TasP, PrEP, condoms... That's... AMAZING. So, then, how is AIDS still a THING then?"
Silver answers with sadness and concern in his face, "Well, many things come at play there. There's a huge lack of funding, so the people and organizations fighting against the virus can't do their work. As a result, a lot of people across the world don't have access to information, tests and therapy. So we end up with people who are not tested nor taking a treatment. And it's not the "not knowing" that's the most dangerous thing; an HIV-positive person who doesn't know their status can be highly contagious."
Page 7
NARRATION: In conclusion, what I've learned these past years is that one of the best ways to fight HIV is to know as much as possible about it.
Silver sits in a medical office, happily getting his blood drawn by a friendly medical practitioner, accompanied by the narration, "It is so important to know your status, so get tested."
We see an overhead shot of three naked men from the shoulders up as they lay in bed together. One of them is holding up a condom package. They all look excited and horny. The narration next to them reads, "You have to feel free to talk about it with your partners and choose the protection that is best for you."
Silver addresses us, the audience, saying "Personally, I've been on PrEP for a long time and I love it, it's helped change my relationship with sex. Even though I sometimes still use condoms, it's given me the option to not HAVE to use them out of fear of HIV, though they're still needed to prevent other STDs."
A rows of fists stand at attention on either side of a floating, looped red ribbon, along with the text, "The fight against HIV/AIDS is far from over yet, especially for lower-income populations. But we don't have to live in the constant fear of it. We have great tools like condoms, PrEP or TasP and the treatments have never been more efficient. Together we're gonna fight this thing.
By Silver * Silverillustrations.com. Read more comics on OhJoySexToy.com. Artist owned and Patreon supported: patreon.com/OhJoySexToy
Transcription by Erika Moen, October 8, 2023