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How Do You Talk About It? Two Guys Take on Undetectable

November 12, 2013

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Zachary: I think that's the problem here. People are basically looking for a checklist: "With a partner who has an undetectable viral load, you can do this and this and this." Honestly, people are hesitant to give that checklist because of liability. People's personal practices around this scenario differ from what they will say in public simply because they don't want to be held liable for a rare occurrence that ends up hurting someone.

So I think the safest thing we can say is that being undetectable massively reduces any chance of transmission. It adds a huge layer of protection against transmission -- and, similarly, PrEP adds that huge layer of protection for a negative person. With the addition of condoms, you honestly have nothing to worry about, right?

And with any behaviors outside of that model, you run into so many variables that you're going to have to take the burden of knowledge onto yourself. We can't give you a cheat sheet for that. People need to understand those variables and make educated decisions about what level of risk they are comfortable with.

You know, a former scientific advisor for the charity that I run spoke at the International Mr. Leather competition a couple years ago, and for his Q&A session, he chose to talk about PrEP. If you're not going to use condoms, he said, PrEP is an amazing alternative to help protect you from acquiring HIV. And it was this huge, huge deal. Similarly, when I wrote my piece in the Advocate about disclosing my status and talking about being undetectable, I got so much hate mail saying that condoms are the only thing.

As soon as you start saying anything else works besides condoms, you're opening Pandora's box, and you're responsible for everything that follows.


Derek: That's the worst. I can't stand that.

Zachary: I think when the condom line was really being enforced, it worked. For a while, it did curb infection rates -- and then it stopped. And I believe the reason it stopped is that the visible reminders of the burden of HIV decreased, and people stopped being afraid of the consequences, because now the consequences are less intimidating.

Derek: There is a lot of controversy in the community, and you have two parts to both generations: You have older guys who only believe in condoms, and you have older guys who only bareback. And then you have younger guys who are loving barebacking and they don't know much about HIV, and younger guys who are like, "Oh my God, I'm in a long-term relationship of five years and we always use condoms."

So it's critical to find that gray area and get people to understand that there are other prevention tools [like PrEP and undetectable viral load] that can help if sometimes you "slip up," or you get intoxicated, and you don't wear a condom.

We've talked about how you address "undetectable" with potential partners; how do you talk about it with friends, or people in your family, or folks you know professionally -- people whose stake in that conversation is different?

Zachary: In my family, they rely on me to kind of guide them about my health and my check-ups. And I think the word "undetectable" has definitely leaked into mainstream language. I think that people naturally understand it's a good thing, that it means you're in a better spot.

I think the question around sexual behavior is harder for people to broach because people are inherently a little prudish. It can be difficult to talk about sex with your family! But I think a situation that is more interesting is talking with family members of partners.

I'm openly positive, and my serious relationships just happen to have been with negative guys. Coming in contact with their families and developing family relationships -- that can be very challenging, because people are naturally protective of their kin and their offspring.

Sometimes that's the more in-depth conversation, where you actually have to walk them through a bunch of research and terminology to say, "I'm not putting your son at risk, and I'm actively mitigating as much of the risk as I can through X, Y, and Z."

I think that's a situation, more often than not, that's more challenging. One would hope your own family would do the best they can to mitigate stress for you and support you wherever they can. Your partner's family may not have that perspective, you know? Their prerogative may be, "I want you to completely reduce any potential harm to my son, my baby."

So I think that's the situation -- more than disclosing to a partner, even -- where you really have to be versed, and comfortable with leading someone to a more knowledgeable position, and comfortable being patient with them. Because the initial reaction may not be encouraging.

Derek: I agree with Zachary. We're trying to destigmatize HIV status within the gay community, and education about what undetectable viral load means for HIV health and HIV transmission is a huge part of that. With our families and others who may just now be accepting us as gay, you're adding another layer: What does it mean to be HIV positive and gay?

I think really educating friends and family and just being as open and honest and communicative as you can is the key. That's how I've always tried to live my life. I love education; I can't say it enough!

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