The tenuous relationship between duty and pleasure is one that has underwritten HIV/AIDS activism since the early 1980s. Most recently the tensions between duty and pleasure surfaced again in the debates concerning Truvada, an HIV-prevention pill that, if taken daily, can reduce risk of infection by up to 92%. Using the debates over pre-exposure prophylaxis (or PrEP) as a catalyst, the chapter examines the implications this technology has for the civic identities of queer men, their safe-sex practices, and AIDS activism. As HIV has moved from being an epidemic to an endemic, the ways queer men come to understand themselves in relation to this manageable condition is evolving. Members of queer communities now exist, by association, as “chronic citizens.” This rendering of citizenship influences the ways we understand traditional postulates concerning duty and pleasure, looking for ways to avoid sex shaming while thinking through new avenues for queer world making.