I have a bit of a different answer to this question.
I feel a lot of this is concerned with guilt and also fault. Gay men are in an almost impossible situation. We have had to worry about HIV for nearly 40 years now and the guilt that has come from that.
For me, I literally went through mental illness for nearly 20 years, convinced I had HIV. I was Obsessive Compulsive and literally ended up in hospital , thinking anyone I touched would get it. Needless to say my sex life was non existent. Do you know how much all that treatment and visits and doctors and cost to family and friends and myself both emotionally and , financially cost?. A fortune.
So why now? I think when you discuss getting the bug, it seems quite simple, but I imagine that for quite a few people it takes years to come to a decision to bareback, let alone with Poz guys.
We have been educated on Sex equals death since the very beginning and I am sorry I blame a lot of that and the subsequent Bareback,Brotherhood Poz on basically American Gay and HIV specialists. Why? Because in the US for at least 15 years, anything you did sexually could almost certainly lead to AIDS. I remember reading how you needed to be sure a guy was clean , before you rimmed a guy with plastic wrap. In Australia, where I was from, the doctors took a much more pragmatic approach, on how you got HIV and if it was low risk, they rarely discussed it.
In America, it seemed everything was taken to an extreme and so in a way it was not a surprise , that an extreme response occurred , or that Barebacking really took off in the US originally. I could be wrong on all of this, however this is how it felt like for me watching outside.
So if you were to ask straight guys to be responsible for nearly 40 years, you would have had a cure and a vaccination on Day 7 of the crisis. Instead we have had to deal with an unending onslaught of negative press about sex. Then we suddenly have medication that slows down the process and other medication which can help stop it occurring. At the same time you have a generation that has grown up without the fear and basically becoming sluts in front of our eyes, when my generation lived in literal fear of death every day.
Now, another thing I would add is the US is in a very privileged position. PREP is not available to many other countries as it is to you and the cost is high to get it. So from where I sit you get cheap PREP, which many countries in the world does not have, how much is the cost being fronted by Insurance companies?
Sorry for the rambling reply. I suppose what I am trying to say is for many of us this is not a Cavalier, let's destroy our health and stuff the consequences, someone else will pay. It is trying to cope with real world dilemmas situations that are difficult to sort out and each person has to come up with their solution.
For me I have spent too long being told what is right and allowing my own life to suffer. I don't actually want to be Poz, but I love sex with poz guys, because there is a freedom with them that I will never have. I understand there is a risk and I hope to God I never become full blown poz, but it is risk I am unable to stop.